拉米夫定联合叶下珠片治疗慢性乙肝的疗效观察和成本-效果分析  

Clinical Effect and Cost-effectiveness Analysis of Lamivudine Combined with Yexiazhu Tablet the Patients with Chronic Hepatitis B

作　　者：张引兰[1,2] 张郁峰[1,2] 刘晓琳[3] 

机构地区：[1]东南大学附属第二医院 [2]南京市第二医院,江苏南京220013 [3]上海交通大学医学院附属仁济医院,上海200127

出　　处：《中医药学报》2012年第5期104-106,共3页Acta Chinese Medicine and Pharmacology

摘　　要：目的:探讨拉米夫定联合叶下珠片治疗HBeAg阳性慢性乙型肝炎的临床疗效及所产生的经济效果。方法:运用药物经济学成本-效果分析方法对83例HBeAg阳性慢性乙型肝炎(分为联合用药组和单纯使用拉米夫定组)进行回顾性分析评价。结果:治疗效果方面两药联用在HBeAg和HBV-DNA转阴率方面疗效明显优于单用拉米夫定,成本-效果分析上,两药联用在HBeAg转阴率方面的C/E较高;拉米夫定在ALT复常和HBV-DNA转阴方面C/E略有优势。结论:拉米夫定单独或联合叶下珠片治疗乙肝疗效对比和C/E分析显示,联合用药在整体评价上具有一定的优势,说明在使用拉米夫定抗HBV治疗的同时,阶段性联合叶下珠片治疗,可以增加慢性乙肝患者对拉米夫定的应答敏感性,以期降低耐药性和变异率,提高抗病毒治疗的疗效,达到长期抑制乙肝病毒复制之目标。Objective ： To investigate Lamivudine and Yexiazhu tablets in the treatment of HBeAg - positive chronic hepati- tis B and the resulting economic effects. Methods：According to pharmacoeconomic cost - effectiveness analysis meth- od, 83 patients with HBeAg- positive chronic hepatitis B （divided into combined group, and simple Lamivudine group） were retrospectively analyzed and evaluated. Results ： According to the treatment effect, the effect of combined group was significantly better than simple Lamivudine group in HBeAg and HBV - DNA negative rate. According to cost - effec- tiveness analysis, C/E of combined group was higher in the HBeAg seroconversion rate; C/E of simple Lamivudine group was higher in ALT normalization and HBV - DNA negative aspects. Conclusion：Lamivudine alone or combination of Lamivudine and Yexiazhu tablets in the treatment of Phyllanthus Comparative efficacy of hepatitis B and C/E analysis shows that the overall evaluation of combination therapy has certain advantages. Lamivudine in combination with Yexi- azhu tablets by phases can increase response sensitivity to Lamivudine in chronic hepatitis B patients, so as to minimize resistance and mutation rate, and improve the efficacy of antiviral therapy, finally to achieve the target of long - term suppression of hepatitis B virus replication.

关 键 词：拉米夫定 叶下珠片 临床疗效 成本-效果分析 

分 类 号：R512.62[医药卫生—内科学]