复方三叶香茶菜片联合拉米夫定治疗慢性乙型肝炎疗效观察.docVIP

复方三叶香茶菜片联合拉米夫定治疗慢性乙型肝炎疗效观察 　　【 摘要】目的 探讨复方三叶香茶菜片联合拉米夫定治疗慢性乙型肝炎的疗效及免疫机制。方法 选择96例ALT大于正常值2倍、血总胆红素水平小于正常值2倍、HBV-DNA均为阳性的慢性乙肝患者,按照随机数字表分为两组,在应用甘草酸二铵注射液保肝降酶治疗的基础上,治疗组46例服用复方三叶香茶菜片联合拉米夫定,拉米夫定100mg/d,每日1次,复方三叶香茶菜片4粒,每日3次,对照组50例拉米夫定治疗,100mg/d,每日1次。疗程均为24周。观察2组在用药后ALT情况、乙肝表面抗原(HBsAg)、乙肝病毒e抗原(HBeAg)、乙肝病毒脱氧核糖核酸(HBV-DNA)转阴率及外周血T细胞亚群情况。 结果 治疗组在疗程4周时ALT逐渐出现下降趋势,对照组至16周时ALT才出现下降趋势。治疗组乙肝病毒e抗原(HBeAg)、HBeAg/抗HBe血清转换、乙肝病毒脱氧核糖核酸(HBV-DNA)转阴率分别为37.0%、23.9%、93.4%,对照组乙肝病毒e抗原(HBeAg)、HBeAg/抗HBe血清转换、乙肝病毒脱氧核糖核酸(HBV-DNA)转阴率分别为16.0%、2.0%、76%,2组病例的HBeAg 、HBeAg/抗HBe血清转换、HBV-DNA阴转率比较均有显著性差异(P0.05)。两组治疗均对T细胞亚群有调节作用,能使CD4+上升 ,CD8+下降 ,CD4+/CD8+上升 ,但治疗组优于对照组(P0.05)。结论 复方三叶香茶菜片联合拉米夫定治疗慢性乙型肝炎有协同作用,可以提高慢性乙型肝炎患者细胞免疫,其抗病毒疗效优于单用拉米夫定。 　　【关键词】 复方三叶香茶菜片 拉米夫定慢性乙型肝炎 　　中图分类号:R512.62 文献标识号:A文章编号:1005-0515(2010)09-012-03 　　【Abstract Objective】 Objective explore the compound trilobites spiced tea vegetables slices joint lamivudine treatment for chronic hepatitis b curative effect and the immune system. Methods selection 96 serum ALT than normal blood 2 times, less than normal total bilirubin level 2 times, hbv-dna all positive for patients with chronic hepatitis b, according to random Numbers table divided into two groups, in the application of glycyrrhizic acid and diammonium injection protect liver enzyme treatment down, on the basis of 46 cases in treatment group taking compound trilobites spiced tea vegetables slices joint lamivudine, lamivudine 100mg/d, once-daily, compound trilobites spiced tea food 4, 3 times a day, 50 cases of lamivudine therapy, 100mg/d, daily 1 times. A course for 24 weeks. Observe the 2 groups in ALT, hepatitis b surface antigen (HBsAg), the second liver virus e antigen (HBeAg) and hepatitis b virus (HBV-DNA) turn rate and peripheral T lymphocyte subsets. Results the treatment group in treatment 4 weeks decrease gradually when ALT group, to 16 weeks only ALT decline. Treatment group e antigen (HBV), HBeAg/resistance HBeAg HBe serum conversion, hepatitis b virus (HBV DNA - DNA) turn 37.