摘要
①目的探讨乙型肝炎e抗原(HBeAg)阳性慢性乙型肝炎患者采用替诺福韦联合苦参素治疗的临床效果。②方法选取本院肝病科86例HBeAg阳性慢性乙型肝炎患者,随机分为替诺福韦对照组(43例)和替诺福韦+苦参素观察组(43例),对照组给予替诺福韦1次/天,300mg/次;观察组同时给予苦参素胶囊,3次/天,0.2g/次,治疗48周,比较两组患者治疗前及治疗24、48周后的血清丙氨酸氨基转移酶ALT(alanine amino transferase)、天冬氨酸转氨酶AST(aspartic acid transaminase)、总胆红素TBIL(total bilirubin)水平;同时比较治疗48周后,两组患者生化学应答率、病毒学应答率、联合应答率、HBeAg血清转换率以及无应答率。③结果治疗24、48周后,两组患者的ALT、AST、TBIL水平均较治疗前显著降低,且相同治疗时间点比较,观察组较对照组下降明显,差异有统计学意义(P<0.05)。连续治疗48周后,两组患者肝功指标较治疗24周显著降低,差异有统计学意义(P<0.05)。治疗48周后,比较观察组和对照组的生化学应答率、病毒学应答率、HBeAg血清学转换率、联合应答率,两组间差异有统计学意义(P<0.05)。但观察组和对照组的无应答率组间比较差异无统计学意义(P>0.05)。④结论替诺福韦联合苦参素治疗HBeAg阳性慢性乙型肝炎疗效优于单用替诺福韦治疗。
Objective To investigate the clinical effect of tenofovir combined with oxymatrine in the treatment of HBeAg positive chronic hepatitis B patients. Methods The observation objects were 86 patients with HbeAg positive chronic hepatitis B who were treated in Department of Hepatology of our hospital from November 2017 to November 2018.The 86 patients with chronic hepatitis B were randomly divided into two groups,43 cases in each group,the control group was treated with tenofovir 1 time a day,300mg/time;At the same time the observation group received oxymatrine capsules 0.2g/time,3 times a day,continuous treatment for 48 weeks.The serum alanine amino transferase(ALT),aspartic acid transaminase(AST),total bilirubin(TBIL) level of the observation group and the control group before treatment and 24 weeks after treatment,48 weeks after treatment were compared.At the same time,biochemical response rate,the rate of virological response,combined response rate,HBeAg seroconversion rate,non response rate of the two groups after 48 weeks treatment were compared. Results After 24 and 48 weeks treatment,ALT,AST,TBIL levels of two groups were decreased significantly,and the ALT,AST,TBIL levels of patients in the observation group were significantly lower than those in control group,with significant difference( P < 0.05 ).After 48 weeks of treatment,ALT,AST,TBIL levels of two groups were significantly reduced compared with those after treatment of 24 weeks, with significant difference( P < 0.05 ).After 48 weeks of treatment,the biochemical response rate,the rate of virological response,combined response rate,HBeAg seroconversion rate of the observation group group were significantly higher than those in the control group,with significant difference( P < 0.05 ).But the non response rate of two groups had no significant difference ( P > 0.05 ). Conclusion Tenofovir combined with oxymatrine in the treatment of HBeAg positive chronic hepatitis B patients is superior to single tenofovir treatment.
作者
孙菲
纪相芬
苏维玮
王经伟
SUN Fei;JI Xiangfen;SU Weiwei(Department of Hepatology/Department of Infectious Diseases,Qilu Hospital of Shandong University,Qingdao 266000,China)
出处
《华北理工大学学报（医学版）》
2019年第3期207-210,215,共5页
Journal of North China University of Science and Technology：Health Sciences Edition
