抗肝纤方联合γ-干扰素治疗慢性乙型肝炎肝纤维化的临床研究

A Clinical Study on the Treatment of Hepatic Fibrosis in Chronic Hepatitis B by Kangganxian Fang Associated with γ- Interferon

目的:观察抗肝纤方联合γ-干扰素对慢性乙型肝炎肝纤维化标志物的影响。方法:将110例患者随机分为3组。对照组30例,采用一般护肝治疗;治疗1组40例,采用γ-干扰素治疗;治疗2组40例,采用抗肝纤方加γ-干扰素治疗。主要观察治疗前后影像学指标及肝纤维化标志物血清Ⅲ型前胶原肽(PIIIP)、透明质酸(HA)、Ⅳ型胶原(Ⅳ-C)、层粘蛋白(LN)和肝纤维化程度等的变化。结果:治疗后治疗1、2组脾脏厚度恢复正常,门静脉内径明显缩小,与治疗前比较,差异均有显著性意义 (P<0．05);其中治疗2组与对照组比较,差异有显著性意义(P<0．05)。治疗后治疗1、2组肝纤维化各项指标与治疗前比较,差异均有显著性意义(P<0．05);治疗2组HA、PIIIP与治疗1组比较,差异均有显著性意义(P<0．05)。治疗后2组炎症分级、炎症计分、肝纤维化分期及肝纤维化计分与治疗前比较,差异均有显著性意义(P<0．05);治疗2组与治疗1组比较,差异均有显著性意义(P<0．05)。结论:干扰素联合中药复方抗肝纤方可能具有更好的抗肝纤维化功效。

Objective： To observe the influence of Kangganxian Fang （KF） associated with γ-interferon on the label of hepatic fibrosis （HF） in chronic hepatitis B, Methods： 110 cases were allocated to 3 groups randomly. The control group （30 cases） was treated by common liver protection therapy, treatment group Ⅰ （40 cases） by γ-interferon, treatment group Ⅱ by KF associated with γ- interferon. The image parameters, the labels of type III serum procollagen peptide （PIIIP）, hyaluronic acid （HA）, type Ⅳ collagen （Ⅳ-C）, laminin （LN） and severity of HF were observed before and after treatment. Results： In treatment group Ⅰ and Ⅱ, the thickness of spleen was recovered to normal, the internal diameter of portal vein was markedly reduced, being significant different （P 〈 0.05） as compared with before treatment, and compared between treatment group Ⅱ and control group. After treatment, the parameters of HF of treatment group Ⅰand Ⅱ were significantly different （P 〈 0. 05） as compared with before treatment. HA and PIIIP of treatment group Ⅱ were significantly different to treatment group Ⅰ （P 〈 0. 05）. After treatment, the grading of inflammation, scoring of inflammation by HF stages and scoring of HF of Ⅰ and Ⅱ groups were significantly different （P 〈 0. 05） as compared with before treatment, and compared between group Ⅰ and Ⅱ. Conclusion： KF combined with γ-interferon possesses a better effect for counteracting HF.