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目的:探讨临床上使用拉米夫定和阿德福韦酯联用与恩替卡韦单药初治慢性乙型肝炎实际疗效对比。方法:我们对2014年3月-2015年3月期间来我院就诊治疗的70例乙型肝炎患者的临床资料进行回顾性研究。我们按照随机分配的方式将这些患者随机分为单一用药组和联合用药组,并保持这两组患者的数量一致,各35例。我们对单一用药组患者使用恩替卡韦药物进行治疗,使用拉米夫定和阿德福韦酯联合方式进行药物治疗,之后对比观察两组患者的治疗效果及肝肾功能、HBVDNA以及乙肝三系等指标,并观察两组患者可能出现的不良反应。结果:经过治疗观察与随访记录,我们发现两组患者在HBVDNA阴转率以及ALT复常率等指标方面相比并没有显著的差异,不具有统计学意义(p>0.05)。另外,单一用药组患者中有4例发生了不良反应,联合用药组患者中有3例患者发生了不良反应,二者相比仍然不具有明显的差异(p>0.05),不具有统计学意义。结论:临床上使用拉米夫定和阿德福韦酯联用与恩替卡韦单药初治慢性乙型肝炎实际疗效差异不大,虽然都不会引发明显的不良反应,但拉米夫定和阿德福韦酯这两种药物联合应用并没有起到更好的治疗效果。
Objective: To investigate the clinical efficacy of lamivudine and adefovir dipivoxil combined with entecavir monotherapy naive chronic hepatitis B. METHODS: We retrospectively reviewed the clinical data of 70 hepatitis B patients who came to our hospital from March 2014 to March 2015 for treatment. We randomly assigned patients to single-agent and combination groups and maintained the same number of patients in both groups, 35 in each. We treated patients in a single drug group with entecavir medications and treated them with lamivudine and adefovir dipivoxil, and then compared the effects of treatment, liver and kidney function, HBVDNA, and hepatitis B triad , And observed two groups of patients may appear adverse reactions. Results: After treatment and follow-up records, we found there was no significant difference between the two groups in terms of negative rate of HBVDNA and ALT normalization rate (p> 0.05). In addition, 4 patients in the single drug group had adverse reactions, 3 patients in the combined drug group had adverse reactions, and there was still no significant difference between the two groups (p> 0.05), which was not statistically significant . Conclusion: The clinical efficacy of lamivudine and adefovir dipivoxil combined with entecavir monotherapy for initial treatment of chronic hepatitis B is of little difference. Although no obvious adverse reactions are induced, lamivudine and The combination of both drugs, adefovir dipivoxil and do not have a better therapeutic effect.