替比夫定联合苦参素治疗HBeAg阳性慢性乙型肝炎的疗效观察

目的观察替比夫定联合苦参素治疗HBeAg阳性的慢性乙型肝炎的疗效。方法65例HBeAg阳性的慢性乙型肝炎患者被随机分为联合治疗组33例，给予替比夫定600mg/d，苦参素片0．6g/d；单用组32例仅给予替比夫定治疗。观察治疗12周、26周、52周时的应答反应情况。结果联合组和单用组HBVDNA阴转率在12周时分别为45．4％和31．3％，两组比较差异无显著性（P〉0．05），但在第26周（72．7％vs46．9％），52周（81．8％vs59．4％）时，两组比较差异有显著性（P〈0.05）。联合组和单用组HBeAg／HBeAb血清转换率在12周时分别为12．1％和6．3％，两组比较差异无显著性（P〉0．05），但在第26周（30．3％V89．38％）、52周（45．5％vs21．9％）时，两组比较差异有显著性（P〈0．05）。两组肝功能复常率在12周、26周、52周差异无显著性（P〉0．05）。在两组患者治疗过程中，均未发现明显副作用。结论替比夫定和苦参素联用能显著提高对慢性乙型肝炎患者的抗病毒疗效。

The clinical effect of telbivudine combined with oxymatrine for Patients with HBeAg positive chronic hepatitis B

ObjectiVe To observe the effects of telbivudine combined with oxymatrine in patients with HBeAg positive chronic hepatitis B. Methods 65 cases of HBeAg positive CHB were randomly divided into two groups. In combined group（33 cases）,telbivudine was given 600 mg once a day and oxymatrine 0.6g/d. In telbivudine group （32 cases）,telbivudine was given alone. Clinical evaluation and laboratory detection were performed at the 12,26,52 weeks of the follow up period. Results At 12 weeks,undetectable rates of serum HBV DNA in combination group and telbivudine group were 45.4% and 31.3% respectively（P〉 0.05）;at 26 weeks,the rates were 72.7% and 46.9%,respectively （P〈0.05）;at 52 weeks,the rates were 81.8% and 59.4%,respectively （P〈0.05）. Seroconversion rates of HBeAg/HBeAb in combination group and telbivudine group were 12.1% and 6.3% respectively at 12 weeks（P〉0.05）,But the seroconversion rates were 30.3% and 9.38% respectively at 26 weeks（P〈0.05）; the seroconversion rates were 45.5% and 21.9% respectively at 52 weeks （P〈0.05）. The normalization rates of ALT and TBIL in the two groups had no statistically significant difference （P〉0.05）. There were no severe adverse reaction in both groups. Conclusion Telbivudine combined with Oxymatrine could enhance the effect of antivirus therapy for patients with chronic hepatitis B.