中医“治未病”理论干预慢性乙型肝炎临床疗效观察(1)
[摘要] 目的 探讨运用中医“治未病”理论联合拉米夫定治疗慢性乙型肝炎的临床疗效。 方法 将512例慢性乙型肝炎患者随机分为两组，每组256例。对照组患者予拉米夫定口服，治疗组予中医“治未病”理论干预及联合拉米夫定治疗，总疗程24个月，分阶段观察患者的HBeAg阴转率、ALT复常率、HBV-DNA阴转率。 结果 治疗组在ALT复常率、HBeAg阴转率、HBV-DNA阴转率方面均明显优于对照组(P<0.05)。 结论 运用中医“治未病”理论联合拉米夫定治疗慢性乙型肝炎，可提高ALT复常率、HBeAg阴转率、HBV-DNA阴转率，提高临床治疗效果。
[关键词] 中医药；治未病；慢性乙型肝炎
[中图分类号] R259 [文献标识码] B [文章编号] 1673-9701(2015)19-0113-04
Effect of the theory of "preventive treatment of disease" in the treatment of chronic hepatitis B
, http://www.100md.com
WANG Shumin ZOU Hai
Infections Department， Lishui City People's Hospital in Zhejiang Province， Lishui 323000， China
[Abstract] Objective To verify the clinical efficacy of traditional chinese theory of "preventive treatment of disease" combined with Lamivudine in the treatment of chronic hepatitis B. Methods A total of 512 patients with chronic hepatitis B were randomly divided into two groups， with 256 cases in each group. The control group received oral Lamivudine administration. The traditional chinese theory of "preventive treatment of disease" combined with Lamivudine were applied in the observation group. The course of treatment was 24 months. Values of ALT， negative rate of HBeAg， negative rate of HBV-DNA were observed in different group and different stages. Results The results of observation group in values of ALT， negative rate of HBeAg， negative rate of HBV-DNA were superior to those of the control group(P<0.05). Conclusion Application of traditional chinese theory of "preventive treatment of disease" combined with Lamivudine can improve values of ALT， negative rate of HBeAg， negative rate of HBV-DNA， and also improve the clinical efficacy in the treatment of chronic hepatitis B.
, 百拇医药
[Key words] Traditional Chinese medicine； Preventive treatment of disease； Chronic hepatitis B
我国是乙型肝炎病毒(HBV)感染的重症受灾区，约50%～70%的人群有HBV感染史，据卫生部2008年4月公布的全国人群乙肝流行病学调查报告显示，我国1～59岁人群的HBsAg阳性率为7.18%。目前乙型肝炎治疗的主要方法是抗病毒治疗。但是，抗病毒治疗存在病毒的高耐药性及病毒高变异率、少数患者对抗病毒治疗的应答及耐受性欠佳等问题。我们应用中医“治未病”理论联合拉米夫定治疗慢性乙型肝炎，取得较好的临床效果，现报道如下。
1 资料与方法
1.1 一般资料
入组患者选择2008年7月～2012年7月间在我院住院治疗及肝病门诊就诊的患者512例，所有患者符合2001年《病毒性肝炎防治方案》[1]的慢性乙型肝炎诊断标准：①血清HBsAg、HBeAg阳性，抗-HBe阴性；②组织学检查有肝炎病变；③HVB-DNA阳性，ALT持续或反复升高。入选标准：入选病例均符合抗病毒治疗适应证，均为初次服用抗病毒药物[2-4]。年龄最大66岁，最小21岁，无合并HIV、HDV、HCV等相关传染性疾病和遗传性肝病、自身免疫性肝病。排除标准：有明显心、脑、神经、精神病和不稳定糖尿病患者及骨髓抑制者。治疗组256例，男135例，女121例，平均年龄(42±7)岁。对照组256例，男133例，女123例；平均年龄(41±9)岁。两组患者的一般情况、肝功能、HBV-DNA定量比较差异均无统计学意义(P>0.05)，具有可比性。
1.2 治疗方法
1.2.1 对照组 嘱患者日常生活注意避免劳累、饮食清淡、注意休息、避风寒、避免饮酒等良好的生活习惯，避免加重肝毒性药物的摄入。拉米夫定口服方法为：每次100 mg，每天1次，于早餐后30 min服用，总疗程为24个月。, http://www.100md.com(王树民 邹海)
[关键词] 中医药；治未病；慢性乙型肝炎
[中图分类号] R259 [文献标识码] B [文章编号] 1673-9701(2015)19-0113-04
Effect of the theory of "preventive treatment of disease" in the treatment of chronic hepatitis B
, http://www.100md.com
WANG Shumin ZOU Hai
Infections Department， Lishui City People's Hospital in Zhejiang Province， Lishui 323000， China
[Abstract] Objective To verify the clinical efficacy of traditional chinese theory of "preventive treatment of disease" combined with Lamivudine in the treatment of chronic hepatitis B. Methods A total of 512 patients with chronic hepatitis B were randomly divided into two groups， with 256 cases in each group. The control group received oral Lamivudine administration. The traditional chinese theory of "preventive treatment of disease" combined with Lamivudine were applied in the observation group. The course of treatment was 24 months. Values of ALT， negative rate of HBeAg， negative rate of HBV-DNA were observed in different group and different stages. Results The results of observation group in values of ALT， negative rate of HBeAg， negative rate of HBV-DNA were superior to those of the control group(P<0.05). Conclusion Application of traditional chinese theory of "preventive treatment of disease" combined with Lamivudine can improve values of ALT， negative rate of HBeAg， negative rate of HBV-DNA， and also improve the clinical efficacy in the treatment of chronic hepatitis B.
, 百拇医药
[Key words] Traditional Chinese medicine； Preventive treatment of disease； Chronic hepatitis B
我国是乙型肝炎病毒(HBV)感染的重症受灾区，约50%～70%的人群有HBV感染史，据卫生部2008年4月公布的全国人群乙肝流行病学调查报告显示，我国1～59岁人群的HBsAg阳性率为7.18%。目前乙型肝炎治疗的主要方法是抗病毒治疗。但是，抗病毒治疗存在病毒的高耐药性及病毒高变异率、少数患者对抗病毒治疗的应答及耐受性欠佳等问题。我们应用中医“治未病”理论联合拉米夫定治疗慢性乙型肝炎，取得较好的临床效果，现报道如下。
1 资料与方法
1.1 一般资料
入组患者选择2008年7月～2012年7月间在我院住院治疗及肝病门诊就诊的患者512例，所有患者符合2001年《病毒性肝炎防治方案》[1]的慢性乙型肝炎诊断标准：①血清HBsAg、HBeAg阳性，抗-HBe阴性；②组织学检查有肝炎病变；③HVB-DNA阳性，ALT持续或反复升高。入选标准：入选病例均符合抗病毒治疗适应证，均为初次服用抗病毒药物[2-4]。年龄最大66岁，最小21岁，无合并HIV、HDV、HCV等相关传染性疾病和遗传性肝病、自身免疫性肝病。排除标准：有明显心、脑、神经、精神病和不稳定糖尿病患者及骨髓抑制者。治疗组256例，男135例，女121例，平均年龄(42±7)岁。对照组256例，男133例，女123例；平均年龄(41±9)岁。两组患者的一般情况、肝功能、HBV-DNA定量比较差异均无统计学意义(P>0.05)，具有可比性。
1.2 治疗方法
1.2.1 对照组 嘱患者日常生活注意避免劳累、饮食清淡、注意休息、避风寒、避免饮酒等良好的生活习惯，避免加重肝毒性药物的摄入。拉米夫定口服方法为：每次100 mg，每天1次，于早餐后30 min服用，总疗程为24个月。, http://www.100md.com(王树民 邹海)