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目的观察拉米夫定联合苦参素治疗HBeAg阳性慢性乙型肝炎患者临床疗效和抗病毒效果。方法收集慢性乙型肝炎患者124例,随机分为2组,治疗组给予拉米夫定加苦参素治疗,对照组单用拉米夫定。分别检测ALT、TBIL、HBV DNA、HBV-M、血生化指标,记录不良反应。结果治疗组HBV DNA阴转率在治疗72周、96周分别为90.3%、91.9%;对照组分别为74.2%、72.6%,二组比较差异均有统计学意义(P<0.05)。治疗组HBeAg/HBe-Ab血清转换率在治疗24周、48周、72周、96周分别为25.8%、37.1%、41.9%、43.5%;对照组分别为9.7%、19.4%、19.4%、24.2%,二组比较差异均有统计学意义(P<0.05)。两组ALT和TBIL复常率差异无统计学意义(P>0.05)。结论拉米夫定联合苦参素治疗HBeAg阳性慢性乙型肝炎可显著提高HBeAg/HBeAb血清转换率和长期的抗病毒疗效,安全性好。
Objective To observe the clinical efficacy and antiviral effect of lamivudine combined with oxymatrine in the treatment of HBeAg-positive chronic hepatitis B patients. Methods 124 patients with chronic hepatitis B were collected and randomly divided into 2 groups. The treatment group was treated with lamivudine plus matrine, while the control group was lamivudine alone. ALT, TBIL, HBV DNA, HBV-M and blood biochemistry indexes were detected respectively, and the adverse reactions were recorded. Results The negative conversion rate of HBV DNA in the treatment group was 72.3% at 72 weeks and 91.9% at 96 weeks respectively. The control group was 74.2% and 72.6% respectively. There was significant difference between the two groups (P <0.05). The seroconversion rate of HBeAg / HBe-Ab in the treatment group was 25.8%, 37.1%, 41.9% and 43.5% at the 24th, 48th, 72th and 96th week of treatment, respectively, while that in the control group was 9.7%, 19.4% and 19.4% 24.2%, the difference between the two groups was statistically significant (P <0.05). There was no significant difference in the normalization rate of ALT and TBIL between the two groups (P> 0.05). Conclusion Lamivudine combined with oxymatrine treatment of HBeAg-positive chronic hepatitis B can significantly improve the HBeAg / HBeAb seroconversion rate and long-term anti-virus efficacy, good safety.