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目的观察阿德福韦酯(ADV)联合苦参素治疗HBeAg阳性慢性乙型肝炎(CHB)初治患者的疗效。方法92例HBeAg阳性CHB患者随机分为2组,均予以抗病毒治疗1 a。治疗组44例给予口服ADV胶囊10 mg/次,1次/d,并口服苦参素胶囊200 g/次,3次/d;对照组48例单纯口服ADV胶囊10 mg/次,1次/d。治疗期间动态观察2组患者的血清丙氨酸转氨酶(ALT)水平、HBV血清学指标和HBV DNA定量等变化,动态监测肾功能。结果治疗1a后,2组患者HBV DNA定量和ALT水平均较治疗前显著下降(P<0.05),但2组间无显著性差异(P均>0.05);治疗组HBeAg阴转率、HBeAg/HBeAb转换率及HBV DNA阴转率均显著高于对照组(P均<0.05)。结论苦参素联合恩替卡韦治疗CHB具有协同抗病毒作用,效果显著,值得临床推广应用。
Objective To observe the curative effect of adefovir dipivoxil (ADV) combined with oxymatrine on patients with newly diagnosed HBeAg-positive chronic hepatitis B (CHB). Methods Ninety-two patients with HBeAg-positive CHB were randomly divided into two groups, all of whom were treated with antiviral therapy for 1 year. Forty four patients in the treatment group were given oral ADV 10 mg once daily and oral kushenin 200 g once daily for 48 hours. d. During the treatment, serum alanine aminotransferase (ALT) level, HBV serology and HBV DNA level were dynamically observed in 2 groups to dynamically monitor renal function. Results The levels of HBV DNA and ALT in two groups were significantly decreased after treatment (P <0.05), but there was no significant difference between the two groups (P> 0.05). The HBeAg negative rate, HBeAg / HBeAb conversion rate and HBV DNA negative conversion rate were significantly higher than the control group (P all <0.05). Conclusions Oxymatrine combined with entecavir has synergistic antiviral effect in the treatment of CHB, which has a significant effect and is worthy of clinical application.