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[目的]观察拉米呋定联合苦参素治疗慢性乙型肝炎(CHB)的疗效及对慢性肝炎病毒P基因(YMDD)变异的影响。[方法]收集乙型肝炎病毒(HBV)HBeAg、HBV-DNA阳性的CHB患者106例,分为拉米呋定联合苦参素(Ⅰ)组、苦参素(Ⅱ)组、拉米呋定(Ⅲ)组。分别检测血清HBeAg、抗-HBe、HBV-DNA、肝脏生化指标和YM-DD变异。[结果]治疗12个月时,Ⅰ组HBeAg/抗-HBe转换率为44.4%,优于Ⅲ组(P<0.05),HBV-DNA阴性率及YMDD变异率较Ⅲ组低(P<0.05)。[结论]拉米呋定联合苦参素在一定程度上提高CHB疗效并可减少YM-DD变异。
[Objective] To observe the curative effect of lamivudine combined with oxymatrine on chronic hepatitis B (CHB) and its effect on the mutation of P gene (YMDD) in chronic hepatitis B virus. [Methods] A total of 106 patients with hepatitis B virus (HBeAg) and HBV-DNA positive CHB were collected and divided into lamivudine combined with kushenin (Ⅰ), oxymatrine (Ⅱ), lamivudine (Ⅲ) group. Serum HBeAg, anti-HBe, HBV-DNA, liver biochemical markers and YM-DD mutation were detected. [Results] The conversion rate of HBeAg / anti-HBe in group Ⅰ was 44.4% at 12 months, which was better than that in group Ⅲ (P <0.05). The negative rates of HBV-DNA and YMDD were lower in group Ⅰ than those in group Ⅲ . [Conclusion] Lamivudine combined with kushenin can improve CHB curative effect and reduce YM-DD variation to a certain extent.