关键词: 慢性乙型肝炎, HBeAg, 恩替卡韦, 苦参素胶囊, 治疗

Abstract: Objective The aim of this study was to explore the short-term efficacy of oxymatrine capsule and entecavir combination in the treatment of patients with serum HBeAg-positive chronic hepatitis B (CHB). Methods 96 patients with HBeAg-positive CHB were enrolled in our hospital between March 2019 and March 2021, and were randomly divided into control (n=48) and observation group (n=48), receiving entecavir or entecavir and oxymatrine capsule combination treatment for 48 weeks. Serum HBV DNA loads were detected by polymerase chain reaction, serum HBeAg was determined by ELISA, the peripheral blood T lymphocyte subsets were measured by flow cytometry, and serum interleukin 10 (IL-10), IL-17 and IL-23 levels were assayed by ELISA. Results At the end of 48 week treatment, serum AST and ALT levels in the observation group were (31.2±4.7)U/L and (38.7±9.4)UL, both significantly lower than [(46.3±6.8)U/L and (66.1±13.6)U/L, respectively, P<0.05] in the control; serum ALT normalization rate in the observation was 83.3%, much higher than 64.6% (P<0.05) in the control; the percentages of peripheral blood CD3⁺ and CD4⁺ cells, and the ratio of CD4⁺/CD8⁺ cells were (73.4±8.1)%, (47.2±6.1)% and (1.9±0.6), all significantly higher than [(66.7±8.8)%, (38.7±4.8)% and (1.6±0.6), respectively, P<0.05] in the control; serum IL-17 and IL-23 levels were (156.8±29.4)ng/L and (22.9±4.2)ng/L, both significantly lower than [(181.7±24.3)ng/L and (26.5±4.6)ng/L, respectively, P<0.05], while serum IL-10 levels was (84.2±5.6)ng/L, significantly higher than [(60.4±6.2)ng/L, P<0.05] in the control group. Conclusion The combination of oxymatrine and entecavir in the treatment of patients with serum HBeAg-positive CHB could effectively improve the short-term serum ALT normalization, which might be related to the improvement of immune functions, and its long-term impact on serum HBeAg loss needs further investigation.

Key words: Hepatitis B, HBeAg, Oxymatrine, Entecavir, Therapy