健肝颗粒Ⅱ方联合恩替卡韦治疗乙肝e抗原阳性慢性乙型病毒性肝炎150例临床观察

Effect of Jiangan Keli Ⅱ and entecavir in treating 150 cases of HBe Ag positive chronic hepatitis B

目的观察健肝颗粒Ⅱ方联合恩替卡韦治疗乙肝e抗原(HBe Ag)阳性慢性乙型病毒性肝炎(CHB)的临床疗效。方法将300例HBe Ag阳性CHB患者随机分为对照组和治疗组,各150例。对照组给予恩替卡韦治疗,治疗组在对照组治疗方法的基础上给予健肝颗粒Ⅱ方。治疗52周后比较2组治疗前后患者外周血丙氨酸氨基转移酶(ALT)、血清乙肝病毒脱氧核糖核酸(HBV-DNA)载量、HBe Ag及乙肝e抗体(HBeAb)血清学转换情况。结果与对照组比较,治疗组HBe Ag转阴率及HBeAb转阳率均显著升高,差异有统计学意义(P<0.05)。与同组治疗前比较,2组外周血ALT及血清HBV-DNA载量显著降低,差异均有统计学意义(P<0.01),且治疗组外周血ALT降低幅度明显大于对照组(P<0.05)。对照组ALT复常率为65.3%,治疗组为78.0%,2组比较差异有统计学意义(P<0.01);对照组血清HBV-DNA载量低于检测限比率为62.7%,治疗组为74.7%,2组比较差异有统计学意义(P<0.05)。结论健肝颗粒Ⅱ方联合恩替卡韦治疗HBe Ag阳性CHB疗效显著,可升高患者的HBe Ag转阴率、HBeAb转阳率、ALT复常率及血清HBV-DNA载量低于检测限比率,其疗效优于单用恩替卡韦。

Objective To observe the clinical effect of Jiangan Keli Ⅱ combined with entecavir in treating HBe Ag positive chronic hepatitis B（ HBe Ag positive CHB）. Methods 300 cases of HBe Ag positive CHB were randomized into control group and treatment group,150 cases in each. The control group was treated with entecavir;the treatment group was intervened with Jiangan Keli Ⅱcombined with entecavir. Treating for 52 weeks,peripheral blood ALT,load of HBV-DNA,serological conversion of HBe Ag and HBeAb were recorded and tested. Results Compared with control group,negative conversion ratio of HBe Ag and positive conversion ratio of HBeAb in treatment group increased obviously,the difference was significant（ P 〈 0. 05）. After treatment,peripheral blood ALT,load of HBV-DNA in both groups decreased notably,the difference was significant（ P 〈 0. 01）,while peripheral blood ALT dropped more in treatment group,there were significant differences（ P 〈 0.05）. Recovery rates of ALT in treatment group and control group were 78.0% and 65. 3% respectively,the difference was significant（ P 〈 0.01）.HBV-DNA ratio to the low limit of detection in treatment group was 74.7%,while that in control group was 62.7%,there was a statistic difference（ P 〈 0.05）. Conclusion The joint therapy is effective in promoting negative conversion ratio of HBe Ag,positive conversion ratio of HBeAb,recovery rate of ALT and HBV-DNA ratio to the low limit of detection. It is better than by using entecavir alone.