论文部分内容阅读
目的观察虫草益肝胶囊联合拉米夫定治疗乙型肝炎HbeAg阳性患者48周的疗效。方法 136例患者平均分为两组,联合治疗组给予虫草益肝胶囊联合拉米夫定,并与单用拉米夫定比较,持续治疗48周。观察治疗不同时间点患者的病毒学、生化学指标、凝血酶原活动度(PTA)及病毒耐药等变化情况。结果两组患者血清HBV DNA治疗后明显下降;联合治疗组在48周时有92.6%的患者HBV DNA阴转;ALT,AST,Tbi1明显下降,白蛋白,PTA等指标均有显著改变(P<0.01);在治疗24,48周时,分别有25.0%(17/68)、36.8%(25/68)的患者出现了HBeAg血清学转换;治疗48周时,联合治疗组YMDD变异率为1.5%。治疗后24,48周HBV DNA水平下降值、HBV DNA阴转率联合治疗组高于拉米夫定组(P<0.05)。结论虫草益肝胶囊联合拉米夫定能快速有效抑制乙型肝炎HbeAg阳性患者的病毒复制,使HBV DNA水平下降,同时可以改善肝功能,且具有较低耐药率。
Objective To observe the curative effect of Cordyceps Yigan Capsule combined with Lamivudine for 48 weeks in patients with HBeAg positive. Methods A total of 136 patients were divided into two groups. The combined treatment group was given Cordyceps Yigangan combined with lamivudine, and compared with lamivudine alone for 48 weeks. The changes of virology, biochemical indexes, prothrombin activity (PTA) and virus resistance of the patients at different time points were observed. Results Serum HBV DNA levels were significantly decreased in both groups after treatment. In the combined treatment group, HBV DNA was negatively transferred in 92.6% of the patients at 48 weeks; the levels of ALT, AST and Tbi1 were significantly decreased, and albumin, PTA and other indicators were significantly changed (P < 0.01). HBeAg seroconversion occurred in 25.0% (17/68) and 36.8% (25/68) of patients at 24 and 48 weeks of treatment, respectively. At 48 weeks, the mutation rate of YMDD in combination therapy group was 1.5 %. After 24 and 48 weeks of treatment, the decrease of HBV DNA level and HBV DNA negative conversion rate were higher than that of lamivudine group (P <0.05). Conclusion Cordyceps Yigan Capsule combined with lamivudine can rapidly and effectively inhibit the virus replication in hepatitis B patients with HBeAg-positive, so as to reduce the level of HBV DNA and at the same time improve the liver function with low resistance rate.