肝康颗粒联合拉米夫定对慢性乙型病毒性肝炎病毒耐药的影响  

Effect of Gankang Granule Combined with Lamivudine on Chronic Hepatitis B Resistant Virus

作　　者：刘琦[1] 任伟宏[2] 禄保平[1] 

机构地区：[1]河南中医学院肝病研究所,河南郑州450008 [2]河南中医学院第一附属医院,河南郑州450001

出　　处：《中医学报》2013年第3期385-387,共3页Acta Chinese Medicine

基　　金：河南省科技厅基础与前沿技术研究项目(编号:112300410031);河南省高校科技创新人才计划(编号:2009HASTIT009)

摘　　要：目的:探讨肝康颗粒联合拉米夫定治疗慢性乙型病毒性肝炎(乙肝)在抑制乙肝病毒突变中的效果,筛查可用于预防乙肝病毒突变的中药或联合制剂。方法:根据治疗方案的不同将187例慢性乙肝患者分为中药组39例、拉米夫定组62例、阿德福韦酯组54例及联合用药组32例。中药组在对症护肝的基础上服用肝康颗粒,不使用任何核苷类抗病毒药物;拉米夫定组口服拉米夫定;阿德福韦酯组服用阿德福韦酯;联合用药组在口服拉米夫定的同时,使用中药肝康颗粒。治疗前后分别检测乙肝病毒耐药水平,对比各组HBV-DNA载量、谷丙转氨酶水平及乙肝病毒耐药率。结果:经相应治疗后,中药组、联合用药组和阿德福韦酯组的突变率与拉米夫定组相比,差异有统计学意义(P<0.05);中药组HBV-DNA含量与阿德福韦酯组和联合用药组比较,差异有统计学意义(P<0.05);各组患者治疗后谷丙转氨酶水平较治疗前比较,有明显下降,但治疗后组间比较均无统计学意义(P>0.05)。结论:肝康颗粒联合拉米夫定对降低慢性乙肝患者HBV-DNA含量有明显效果;与单用拉米夫定相比,可显著降低乙肝病毒的耐药性。Objective ： Discussion of Gankang granule cimbined with lamivudine in the treatment of chronic hepatitis B in the inhibition of hepatitis B virus mutation effect, screening can be used for the prevention of hepatitis B virus mutation in Chinese medicine or combinedpreparation. Methods：According to the different treatment of 187 cases of chronic hepatitis B were divided into traditional Chinese medicine group 39 cases, lamivudine group 62 cases, adeforvir dipivoxil group 54 cases, traditional Chinese cimbined with lamivudine 32 cases. In traditional Chinese medicine group on the basis of symptomatic liver, the dialectical use of chinese medicine or chinese medicine prescription, do not use any nucleoside drug;Lamivudine group oral lamivudine;Adeforvir dipivoxil group oral adeforvir dipivoxil; Combine group oral lamivudine and Gankang granule. Hepatitis B virus resistance levels were detected before anf after treatment, contrast group HBV-DNA load, alanine aminotransferase levels and hepatitis B virus resistant rate. Results：After treatment, the mutation rate of the traditional Chinese medicine group,the combine group and, adeforvir dipivoxil groupt compare with lamivudine group, difference have patency statistically significant （ P 〈 0.05 ） ; Traditional Chinese medicine group HBV-DNA content compare with adeforvir dipivoxil group and combine group,difference have patency statistically significant （P 〈 0.05 ） ;Four groups of patients after the treat- ment of alanine aminotransferase levels than before treament compared, decreased significantly, but after trestment between two groups were not statistically significant（P 〉0.05）. Conclusion ：Traditional Chinese medicine combined with lamivndine has obvious effect on decreasing the content of HBV-DNA in patients with chronic hepatitis B;Compared with lamivudine can significantly reduce the rate of drug resistance of hepatitis B virus.

关 键 词：慢性乙型病毒性肝炎 肝康颗粒 拉米夫定 基因变异 

分 类 号：R259.126.2[医药卫生—中西医结合]