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目的观察分析氧化苦参碱联合拉米夫定治疗慢性乙型肝炎(CHB)的疗效和安全性,探讨联合治疗的协同作用机理。方法将122例HBsAg,HBeAg阳性或HBeAg阴性,而HBV DNA阳性的CHB患者随机分为三个组:①氧化苦参碱联合拉米夫定组;②单用干扰素组;③单用拉米夫定组,疗程均为6个月。观察各组肝功能和乙型肝炎病毒标志(HBVM)的变化情况和不良反应。结果治疗结束时三组临床症状均有不同程度改善。联合组肝功复常率为89.3%。而干扰素组和拉米夫定组分别为65.4%和60.9%。三组有显著性差异;联合组HBeAg阴转率为68.8%,HBV DNA阴转率为82.9%,干扰素组分别为44%和61.9%,拉米夫定组分别为38.1%和59.1%,三组有显著性差异。干扰素组与拉米夫定组均无显著性差异。治疗中干扰素组出现了相关不良反应,其余两组中未见不良反应。结论氧化苦参碱联合拉米夫定治疗CHB有协同抗病毒,保肝等作用。明显改善肝功能,优于单用干扰素组或单用拉米夫定组,提高了疗效,且安全经济。
Objective To observe the efficacy and safety of oxymatrine combined with lamivudine in the treatment of chronic hepatitis B (CHB) and to explore the synergistic mechanism of combination therapy. Methods One hundred and twenty-two patients with HBsAg, HBeAg-positive or HBeAg-negative HBV DNA-positive CHB were randomly divided into three groups: ① oxymatrine combined with lamivudine group; ② interferon alone group; ③ lamivudine alone Fuding group, treatment are 6 months. Observe the changes of hepatic function and hepatitis B virus (HBVM) and the adverse reactions in each group. Results At the end of treatment, the clinical symptoms of the three groups improved to some extent. Combined group liver function recovery rate was 89.3%. The interferon group and lamivudine group were 65.4% and 60.9%. The negative rate of HBeAg in combination group was 68.8%, HBV DNA negative conversion rate was 82.9%, interferon group was 44% and 61.9%, lamivudine group was 38.1% and 59.1% respectively, Three groups have significant differences. There was no significant difference between interferon group and lamivudine group. Interferon treatment group appeared related adverse reactions, the remaining two groups no adverse reactions. Conclusion Oxymatrine combined with lamivudine treatment of CHB has synergistic antiviral and hepatoprotective effects. Significantly improve liver function, better than interferon group alone or lamivudine alone group, improve the efficacy, and safe and economical.