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[目的]观察拉米夫定联合苦参素治疗HBeAg阳性慢性乙型肝炎(CHB)的临床疗效。[方法]将140例CHB患者随机分为2组,治疗组70例给予拉米夫定联合苦参素治疗;对照组70例单服拉米夫定疗程均1 a。比较2组治疗后血清丙氨酸氨基转移酶(ALT)、天冬氨酸转氨酶(AST)复常率,HBeAg/抗-HBe转换率,HBeAg、HBV DNA转阴率,YMDD突变率。[结果]治疗组治疗后12个月血清HBeAg/抗-HBe转换率、HBeAg转阴率、YMDD突变率分别为35.7%、47.1%、12.9%;对照组分别为17.1%、27.1%2、8.6%,2组差异有统计学意义(P<0.05),2组ALT、AST的复常率比较均P<0.05,HBV DNA转阴率P>0.05。[结论]拉米夫定联合苦参素治疗HBeAg阳性CHB疗效优于单用拉米夫定治疗。
[Objective] To observe the clinical efficacy of lamivudine combined with oxymatrine in the treatment of HBeAg-positive chronic hepatitis B (CHB). [Method] 140 CHB patients were randomly divided into two groups. The treatment group was treated with lamivudine combined with oxymatrine. In the control group, 70 cases were treated with lamivudine alone for 1 year. The serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) normalization rate, HBeAg / anti-HBe conversion rate, HBeAg, HBV DNA negative rate and YMDD mutation rate were compared between the two groups. [Results] The serum HBeAg / anti-HBe conversion rate, HBeAg negative rate and YMDD mutation rate were 35.7%, 47.1% and 12.9% respectively in the 12-month treatment group and 17.1%, 27.1% 2 and 8.6 %, There was significant difference between the two groups (P <0.05). The normalization rate of ALT and AST in both groups were P <0.05, and the negative rate of HBV DNA was> 0.05. [Conclusion] Lamivudine combined with oxymatrine is superior to lamivudine alone in the treatment of HBeAg-positive CHB.