慢性乙型肝炎患者应用泌胆剂的益处

The benefit of chloretics in patients with chronic hepatitis B

目的：探讨泌胆剂对慢性乙型肝炎的辅助治疗作用。方法：158例慢性乙型肝炎患者随机分为泌胆剂组和对照组。对照组给予一般护肝治疗，泌胆剂组在一般护肝治疗基础上同时给予泌胆剂（加诺，3次／d，1～2片／次）治疗3月。两组病例如具备抗病毒治疗指针，则给予干扰素抗病毒治疗6个月。比较各组患者治疗中和治疗结束时的生化和／或病毒学指标。结果：和对照组相比，泌胆剂组患者血清ALT、AST和TBil治疗后下降幅度均较大。其中，在非抗病毒患者，泌胆剂组治疗1月和3月时的AST及TBil水平、治疗3月时ALT水平显著低于对照组；在抗病毒治疗患者，泌胆剂组治疗1、3、6月时的TBil水平及治疗1、6月时AsT水平与对照组比较差异有显著意义。在抗病毒治疗的患者，泌胆剂组病毒应答指标（包括治疗3和6月时的HBV DNA阴转率、e系统血清学转换率）以及ALT复常率较高，但未达统计学意义水平。结论：泌胆剂作为慢性乙型肝炎患者的辅助治疗，能改善患者肝功能生化指标。是否增强陧性乙型肝炎干扰素抗病毒疗效有待进一步研究。

Objective： To investigate chloretics as an adjuvant in the treatment of chronic hepatitis B （CHB） . Methods： One hundred and fifty - eight patients with CHB were divided into chlorestics and controls group randomly. Patients of control group were treated with general liver protection therapy, while patients of chloretics group were added chloretics （ Galle Donau, 1 - 2#, tid） for 3 months on the basement treatment. Antiviral therapy with interferon-or was used when needed on both groups. Biochemical liver function and/or viral markers were assayed during and at the end of therapy. Results. Compared with control cases, patients with chlorestics treatment achieved great improvement on serum ALT, AST and TBil level. Among those, the level of AST and TBil at month 1 and 3, as well as the level of ALT at month 3 post therapy were statistically different between the chloretics and control group patients unnecessary for antiviral treatment. While in patients with antiviral therapy, the level of AST at month 1 and 6, as well as the level of TBil at month 1, 3 and 6 were significantly lower in chloretics group patients than that in control patients. While the rate of viremia clearance and the sera convert of e system at month 3 and 6 post antiviral therapy were higher in patients with chloretics than in control patients, the differences were not achieved statistic significance. Conclusion： These results shown that chloretics could improved biochemical test of liver function when used as an adjuvant therapy for CHB. Further study is needed to address the adjuvant antiviral role of chloretics on interferon treatment of CHB.