氧化苦参碱联合复方丹参抗乙肝后肝纤维化的临床价值分析

Clinical Analysis of Oxymatrine Combined with Compound Salvia Miltiorrhiza Bunge in Treatment of Secondary Hepatic Fibrosis in Hepatitis B Disease

目的 :观察氧化苦参碱联合复方丹参治疗乙肝后肝纤维化的逆转作用。方法 :选取乙肝后肝纤维化病人 6 0例 ,分为两组。试验组 30例用氧化苦参碱联合复方丹参片治疗 ,对照组 30例使用水飞蓟素片治疗 ,疗程均为 4～ 6月。测定治疗前后各组血清肝纤维化指标透明质酸、IV型胶原及层粘蛋白 (HA、IV -C及LN)、生化指标血清总胆红素、谷丙转氨酶、谷草转氨酶、白蛋白 (TBIL、ALT、AST、Alb)及乙肝病毒标志物 (HBsAg、HBeAg)变化情况并作统计学处理 ,同时观察实验过程中出现的不良反应。结果 :试验组患者治疗后的血清HA、IV -C及LN水平均明显降低 ,其中尤以HA、IV -C降低显著 (P <0 .0 1) ,TBIL、ALT、AST水平与治疗前相比亦有显著下降。而对照组治疗前、后肝纤维化指标变化不明显 (P >0 .0 5 ) ,生化指标中仅血清ALT明显下降 (P <0 .0 5 )。另外两组患者在治疗后HBsAg、HBeAg阴转率方面存在明显差异。用药期间两组患者均未出现显著不良反应。结论 :氧化苦参碱联合复方丹参在逆转乙肝后肝纤维化中有显著疗效且用药安全。

Objective: To assess the therapeutic effec t of oxymatrine combined with Compound Salvia miltiorrhiza Bunge tablet on seconda ry hepatic fibrosis in Hepatitis B Disease. Methods: 60 patients with Hepatitis B associated with liver fibrosis were randomly divided into expe riment group treated with oxymatrine combined with Compound Salvia miltiorrhiza Bunge tablet (n=30) or control group treated with silymarin (n=30) for c onsecutive 4-6 months and their efficacy and side-effect were observed. The seru m fibrosis markers(hyaluronic acid, type IV collagen, Laminin),biochemical ma rkers(TBIL, ALT, AST, Alb) and viral index(HBsAg, HBeAg) of the two groups were also determined. All the data were processed by statistics. Results: The levels of serum fibrosis markers in experiment group were all significa ntly reduced after treatment,the abnormity of biochemical markers except serum albumin(Alb) was also obviously improved at the end of treatment, whereas only t he level of serum ALT in control group was markedly reduced at the end point com pared with the baseline(P<0.05). meanwhile, serum conversion of viral index( HBsAg, HBeAg) in experiment group is more frequent than in control group, and no severe side-effects occurred during the experiment. Conclusion: Oxymatrine combined with Compound Salvia miltiorrhiza Bunge is an effective and safe remedy for treatment of hepatic fibrosis secondary to hepatitis B disease.