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目的探讨百赛诺联合叶下珠片治疗慢性乙型肝炎的疗效。方法2006年2月至2007年10月,我们对拉米夫定抗病毒治疗结束后复发(A组)、服用拉米夫定过程中出现反弹(B组)及未经抗病毒治疗(C组)的慢乙型肝炎患者共90例,在常规保肝治疗的基础上,予以百赛诺联合叶下珠片治疗三个月,并进行跟踪观察,比较治疗前后肝功能(ALT、AST、A/G)的变化、血清病毒指标(HBV-DNA、HBeAg)阴转率和HBeAg/抗HBe血清转换率,同时以慢性乙肝防治指南中的联合应答标准作疗效判断。结果用百赛诺联合叶下珠片治疗三个月后,A组及C组患者的ALT、AST水平明显改善,具有统计学意义。三组ALT复常率、AST复常率及HBVDNA阴转率达到一定水平,尤以A组疗效突出,复常率和阴转率分别达100%、71.4%、71.4%。而HBeAg阴转率及HBeAg/抗HBe血清转换率以未经抗病毒治疗C组较明显,达46.7%、35.7%。综合各项指标,A、B、C三组的完全应答率分别为53.3%、6.7%、33.3%,部分应答率分别为13.3%、53.3%、20.0%,未应答达33.3%、40.0%、46.6%。结论联合应用百赛诺和叶下珠片对A组及C组慢性乙型肝炎患者疗效显著,对B组患者也能一定程度的使转氨酶复常及阴转其HBV-DNA。百赛诺联合叶下珠片可成为没有条件采用干扰素、核苷类药物抗病毒或对核苷类耐药的慢性乙型肝炎患者临床治疗的一种尝试。
Objective To investigate the curative effect of Baixinuo combined with Phyllanthus in the treatment of chronic hepatitis B. Methods From February 2006 to October 2007, we observed relapse after lamivudine treatment (group A), rebound in lamivudine group (group B) and no anti-virus treatment (group C) ) Of 90 patients with chronic hepatitis B, on the basis of routine hepatoprotective therapy, combined with besaceno combined with Phyllanthus tablets for three months, and follow-up observation of liver function before and after treatment (ALT, AST, A / G), seronegative (HBV-DNA, HBeAg) negative conversion rate and HBeAg / anti-HBe seroconversion rate. At the same time, the curative effect was evaluated according to the combined response criteria in chronic hepatitis B prevention and treatment guidelines. Results With Bai Senuo combined with Phyllanthus tablets three months after treatment, the ALT and AST levels of patients in group A and C were significantly improved, with statistical significance. The ALT normalization rate, AST normalization rate and HBVDNA negative conversion rate of the three groups reached a certain level, especially in the A group, the normalization rate and the negative conversion rate were 100%, 71.4% and 71.4% respectively. However, the negative rate of HBeAg and the rate of HBeAg / anti-HBe seroconversion were significantly higher in C group than in antiviral group (46.7%, 35.7%). According to the indexes, the complete response rates were 53.3%, 6.7% and 33.3% in A, B and C groups respectively. The partial response rates were 13.3%, 53.3% and 20.0% respectively. The unresponsiveness was 33.3% and 40.0% 46.6%. Conclusions The combined application of BSS and Hypsizyphus tablets has a significant effect on patients with chronic hepatitis B of group A and group C, and patients with group B also can make aminotransferase normal and negatively switch to HBV-DNA. Baixessuo combined with Phyllanthus tablets can become an unconditioned use of interferon, nucleoside drugs, antiviral or nucleoside resistant chronic hepatitis B patients with an attempt to clinical treatment.