替比夫定联合苦参素治疗HBeAg阳性慢性乙型肝炎临床观察

Clinical Observation on the Effect of Telbivudine Combined with Kushenin on the Treatment on HBeAg Positive Chronic Hepatitis B Patients

目的:观察替比夫定联合苦参素治疗慢性乙型肝炎的疗效。方法:将入选病例随机分为替比夫定组(A组)和联合治疗组(B组),替比夫定组给予替比夫定600mg/天,1次/日,连用48周;联合治疗组在替比夫定组治疗基础上加用苦参素0.2g,3次/日,连用48周。观察2组肝功能指标、HBV-DNA阴转、HBeAg阴转率及HBeAg血清学转换率的比较。结果:A组24周时HBV-DNA阴转率为46.9%,HBeAg阴转率为21.9%,HBeAg血清学转换率为12.5%;48周时HBV-DNA阴转率为62.5%,HBeAg血清学转换率为31.3%,HBeAg血清学转换率为18.8%。B组24周时HBV-DNA阴转率为65.6%,HBeAg阴转率为37.5%,HBeAg血清学转换率为18.8%。48周时HBV-DNA阴转率为84.4%,HBeAg阴转率为56.3%,HBeAg血清学转换率为40.6%。结论:替比夫定治疗慢性乙型肝炎效果明显,且随时间延长而疗效提高,与苦参素联合,其疗效优于单用替比夫定治疗。

Objective:To observe the effect of Telbivudine combined with Kushenin on the treatment on chronic hepatitis B patients.Methods:All selected chronic hepatitis B patients were randomly divided into one Telbivudine treatment group(group A)and one combination treatment group(group B).Group A was given 600mg of Telbivudine once a day for 48 weeks.Group B was given with 0.2g of Kushenin three times a day besides the same dosage of Telbivudine as Group A for 48 weeks.The liver function indicators,HBV-DNA negative,HBeAg negative conversion rate and HBeAg serum conversion rate of the two groups were observed and compared.Results:In Group A,the HBV-DNA negative conversion rate,HBeAg negative conversion rate and HBeAg serum conversion rate were 46.9%、21.9% and 12.5% respectively after 24 weeks,but the HBV-DNA negative conversion rate,HBeAg negative conversion rate and HBeAg serum conversion rate were and 65.5%、37.5% and 18.8% respectively after 48 weeks.In Group B,the HBV-DNA negative conversion rate,HBeAg negative conversion rate and HBeAg serum conversion rate were 65.6%、37.5% and 18.8% respectively after 24 weeks,but the HBV-DNA negative conversion rate,HBeAg negative conversion rate and HBeAg serum conversion rate were 84.4%、56.3% and 40.6% respectively after 48 weeks.Conclusion:Telbivudine has an obvious effect on the treatment of the chronic hepatitis B patients and extended hours will improve the effectiveness.When combined with Kushenin,Telbivudine shows a better effect than the single use of Telbivudine.