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目的:观察中医健脾补肾法对拉米夫定治疗慢性乙型肝炎早期应答率的影响。方法:将160例患者随机分为对照组和观察组,每组80例。对照组予拉米夫定治疗,观察组在拉米夫定治疗基础上加中医健脾补肾方治疗,疗程均为24周。分别观察比较两组患者12周、24周后ALT、AST、HBV-DNA、乙肝三系的变化和CD4、CD4/CD8的比值。结果:治疗12周、24周后观察组患者肝功能ALT、AST的复常率和HBV-DNA的转阴率明显高于对照组(P<0.05);并且,治疗24周后观察组患者HBeAg血清转阴率和CD4、CD4/CD8比值明显高于对照组(P<0.05)。结论:健脾补肾法可以明显提高拉米夫定治疗慢性乙型肝炎的早期应答率,其机理之一与调节CD4、CD4/CD8水平等有关。
Objective: To observe the effect of Chinese herbal medicine for spleen and kidney on the early response rate of chronic hepatitis B patients treated with lamivudine. Methods: 160 patients were randomly divided into control group and observation group, 80 cases in each group. The control group was treated with lamivudine. The observation group was treated with lamivudine plus Chinese medicine spleen and kidney for 24 weeks. The changes of ALT, AST, HBV-DNA, hepatitis B three-line and the ratio of CD4, CD4 / CD8 were observed and compared between the two groups after 12 weeks and 24 weeks respectively. Results: After 12 weeks and 24 weeks of treatment, the ALT and AST recovery rates and HBV-DNA negative conversion rates in the observation group were significantly higher than those in the control group (P <0.05); and after 24 weeks of treatment, HBeAg Serum negative rate and CD4, CD4 / CD8 ratio was significantly higher than the control group (P <0.05). Conclusion: The method of invigorating the spleen and invigorating the kidney can obviously improve the early response rate of chronic hepatitis B by lamivudine. One of the mechanisms is related to the regulation of CD4 and CD4 / CD8 levels.