拉米夫定联合左旋咪唑涂布剂治疗慢性乙型肝炎的临床研究  

Clinical Observation on Treatment of Chronic Hepatitis B by Combined Use of Lamivudine and Liniment Levamisole

作　　者：徐朝峰[1] 张友定[1] 张凌燕[1] 田义州[1] 

机构地区：[1]舟山市中医骨伤联合医院肝病科,浙江舟山316000

出　　处：《中西医结合肝病杂志》2005年第3期136-138,共3页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：舟山市卫生局资助项目[No.舟山科评字(2004)第17号]

摘　　要：目的:研究拉米夫定联合左旋咪唑涂布剂治疗慢性乙型肝炎的效果,HBVYMDD变异的发生率及停药后远期持续应答率。方法:随机将慢性乙型肝炎(慢乙肝)患者分成治疗组及对照组,对照组患者单用拉米夫定,治疗组在应用拉米夫定基础上加用左旋咪唑涂布剂。治疗前、治疗结束时,采用统一方法检测两组患者的配套肝功能,HBVDNA定量,HBV M;疗程中每3个月检测上述指标各1次并记入患者档案。对疑有HBVDNA变异者,采用统一方法检测YMDD变异及前C区变异。并对停药后的远期疗效进行追踪观察。比较两组的生化学应答,病毒核酸应答,病毒血清学应答,并评价其综合疗效,HBVYMDD变异率及远期持续应答率。结果:治疗组治疗结束时生化学、病毒核酸,病毒血清学完全应答率分别达87.7%、90.4%、41.3%;其综合疗效评价完全应答率也达27.4%;停药后6个月及1年持续应答率分别达62.75%、52.94%,HBVYMDD变异率为9.59%。结论:拉米夫定联合左旋咪唑涂布剂治疗慢性乙型肝炎疗效明显优于单用拉米夫定者,并可减少HBVYMDD变异率,值得临床进一步推广验证。Objective:To study clinically the effect of Lamivudine associated with Levamisole liniment treat chronic hepatitis B virus infection, and the rate of HBV YMDD mutation and persistend responsion at a specified future date while stopping treatment.Methods:The patients with chronic hepatitis B virus infection were divided randomly into treatment group and control group, the treatment group was treated by Levamisole liniment in addition to Lamivudine. Uniform method was used to detect liver function, HBV DNA, HBV-M of the two groups when before and after the treatment. During the treatment the parameters above were detected once every three months, and written onto the patients records.For the uncertain patients with HBV DNA mutation, uniform method was used to detect the YMDD mutation and Pre-C area mutation. And to tracing observe the curative effect after stopping treatment at a long period of time. To compared with the the responsion of biology and chemistry, the responsion of virus nucleic acid, the responsion of virus serology, of the two groups, and to estimate the general curative effect, the rate of HBV YMDD mutation, and the rate of persistent responsion at a specified future date. Results: After the treatment, the rates of complete responsion of biochemistry, virus nucleic acid,virus serology of the treatment group were 87.7%、90.4%、41.3%,and the rate of general curative effect in complete responsion was 27.4%. The persistent responsion after stopping treatment for 6 months and 1 year was 62.75%,52.94%, and the rate of HBV YMDD mutation was 9.59%.Conclusion:The curative effect of Lamivudine associated with levamisole Liniment treat chronic hepatitis B virus infection was more advantage than the effect of Lamivudine only, and it can reduce the rate of HBV YMDD mutation. This method is worth of more clinical use and test.

关 键 词：左旋咪唑涂布剂 慢性乙型肝炎 拉米夫定 临床研究 HBVYMDD变异 完全应答率 病毒核酸 HBV-M DNA变异 前C区变异 血清学应答 病毒血清学 停药后 治疗组 变异率 患者档案 追踪观察 远期疗效 综合疗效 疗效评价 对照组 生化学 

分 类 号：R512.62[医药卫生—内科学] R563.1[医药卫生—临床医学]