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目的 :观察拉米夫定联合乙肝转阴合剂治疗慢性乙型肝炎抗病毒效果及安全性。方法 :64例HBsAg、HBeAg、抗HBc均阳性慢性乙型肝炎病例 ,分 2组 ,联合组口服拉米夫定 10 0mg ,每日 1次 ,同时服用乙肝转阴合剂 2 0ml,每日 3次 ,共 2 4周 ;拉米夫定组 10 0mg ,每日 1次 ,口服 ,共 2 4周。 2组病人在治疗同时均给予肌苷 ,维生素B、C等一般护肝药物治疗 ,不使用其他抗病毒药物及免疫调节剂。结果 :联合组和拉米夫定组在治疗 3个月、6个月时肝功能均有明显改善 ,对HBV -DNA阴转率均在 90 %以上 ,2组比较差异无显著性 (P >0 0 5 ) ;在HBeAg阴转率方面 ,治疗 3个月、6个月时 ,联合组均优于拉米夫定组 ,但 2组比较 ,无统计学意义 (P >0 0 5 ) ;在HBeAg 抗 -HBe血清转换方面 ,治疗 3个月、6个月时 ,联合组分别为 2 7 4%和 3 9 4%显著优于单用拉米夫定组 6 5 %和 16 1% (P <0 0 5 )。结论 :拉米夫定联合乙肝转阴合剂治疗慢性乙型肝炎可明显提高HBeAg 抗 -HBe的血清转换率 ,且疗效稳定 ,复发率低 ,提高抗病毒效果 ,其远期疗效有待进一步观察。
Objective: To observe the anti-virus effect and safety of lamivudine combined with Hepatitis B to transvaginal mixture in treating chronic hepatitis B. Methods: Sixty-four cases of HBsAg, HBeAg and anti-HBc positive chronic hepatitis B cases were divided into 2 groups. The combined group received 100 mg of lamivudine orally once daily while taking 20 mg of hepatitis B toxin mixture and 3 times daily , A total of 2 4 weeks; lamivudine group 10 0mg, 1 day, orally for a total of 24 weeks. Two groups of patients were given at the same time inosine, vitamin B, C and other general liver drug treatment, do not use other antiviral drugs and immunomodulators. Results: The liver function of the combined group and the lamivudine group was significantly improved at 3 months and 6 months after treatment, and the negative conversion rate of HBV-DNA was over 90%, there was no significant difference between the two groups (P> In the negative conversion rate of HBeAg, the combination group was superior to lamivudine group at 3 months and 6 months after treatment, but there was no significant difference between the two groups (P> 0.05). In HBeAg anti-HBe seroconversion, 2 7 4% and 39 4% of the combination group were significantly better than 65% and 16 1% of the lamivudine monotherapy group at 3 and 6 months of treatment P <0 0 5). Conclusions: Lamivudine combined with Hepatitis B to TCD can significantly improve the seroconversion rate of HBeAg anti-HBe with stable curative effect, low recurrence rate and high antiviral efficacy. The long-term therapeutic effect remains to be further observed.