慢性B型肝炎各中醫證型與拉米夫定療效相關性之研究 台灣為B型肝炎的高盛行區，目前國內以LAMIVUDINE(拉米夫定)為B型肝炎治療主軸。然而，LAMIVUDINE治療每位病患的個別療效卻有明顯差異。就此方面而言，本研究希望針對慢性B型肝炎經完整LAMIVUDINE治療，觀察其療效與中醫證型之間的相關性。本研究經中國醫藥大學附設醫院西醫肝膽科及中醫肝膽科篩選慢性B型肝炎患者執行“慢性B型肝炎中醫證型診斷基準表”之問卷調查，接著，我們執行了兩種方式予以分析。第一種是將各中醫證型區分為具備或不具備，藉由SAS電腦統計軟體分析，以相關係數探討LAMIVUDINE療效與具備該中醫證型分數之相關。第一種方式發現， 有關AST值的降低，各證型皆不具有統計上之差異；有關ALT值的降低，脾虛濕阻證型較其他種證型明顯的不易降低(P<0.05)。HBeAg轉陰以及Anti-HBe轉陽表現，七基本證型之間無統計上之顯著差異。第二種方式是以單一證型為主證型之分析。第二種方式發現，停藥時HBeAg轉陰率最高者為肝氣鬱結型與脾虛濕阻與脾腎陽虛型；停藥後6個月以肝氣鬱結型HBeAg轉陰率最高；而停藥時Anti-HBe轉陽率最高為脾腎陽虛型；停藥後6個月以脾虛濕阻型Anti-HBe轉陽率最高；至若停藥時ALT達到正常的表現以脾腎陽虛型與血瘀型最佳；停藥後6個月ALT復發率最低的三證型分別是脾腎陽虛型、脾虛濕阻型、濕熱蘊結型。 關鍵字：中醫證型、拉米夫定、慢性B型肝炎; The relationship between Zheng and the effect of Lamivudine in chronic hepatitis B Taiwna is an popular area of serious of chronic hepatitis B patients，for the time being，Lamivudine is major therapy in Taiwna . But，various patients of Lamivudine therapy is different effect . In the light of the question，we hope to understand the connection about Chinese Medical body type of the individual of chronic hepatitis B patients and the effect of Lamivudine．The research to choose chronic hepatitis B patients of Chinese Medical University Hospital，and to carry out question for patient，and to analysis data with“The SAS System Viewer V8.1” of computer software，we will use connective coefficient to confer a connection of Chinese Medical body type between Lamivudine therapy．We find : AST and HBe-Ag and Anti-HBe of seven Chinese Medical body type no statistical value(P>0.05)， Only ALT of“ pi-xu-shi-zu” Chinese Medical body type have statistical value(P<0.05)．The research will help we to understand which Chinese Medical body type is effective of Lamivudine therapy． Key words：Chinese Medical body type．Lamivudine．chronic hepatitis B
