干扰素α1b联合苦参碱治疗肝炎肝纤维化40例

Clinical evaluation of interferon α1b associated with matrine in the treatment of liver fibrosis in hepatitis B

目的:探讨干扰素α1b联合苦参碱治疗慢性乙型肝炎(CHB)并肝纤维化的疗效及不良反应。方法:选择80例CHB并肝纤维化患者。随机分入试验组及对照组各40例。试验组病例用干扰素α1b联合苦参碱治疗,对照组仅用干扰素α1b治疗,并于治疗前后检测肝功能、病毒标志物及肝纤维化血清学指标(HA,LN,PCⅢ,IV-C)等。结果:试验组与对照组临床总有效率分别为92%和71%(P<0.05),HBeAg阴转率分别为59%和34%(P<0.05);肝纤维化指标明显下降,试验组治疗前后比较有统计学差异(P<0.01),对照组治疗前后比较,HA和LN差异有统计学意义(P均<0.01),PCⅢⅣ-C差异无统计学意义。试验组与对照组治疗后比较有统计学差异(P<0.01)。结论:干扰素α1b联合苦参碱治疗CHB并肝纤维化患者有协同抗乙肝病毒、抗肝纤维化效应。

Objective： To assess the efficacy and safety of combination of interferon α1b with matrine in the treatment of liver fibrosis in chronic hepatitis B （CHB）. Methods ：80 patients with liver fibrosis in CHB were equally randomized to give one of two treatments： interferon α1b plus matrine or interferon α1b alone. The efficacy of the therapy was assessed based on the status of liver functions, virus symbols and indexes of fibrosis serology （ HA, LN, PC Ⅲ, Ⅳ-C ） before and after the administration of drugs. Results：Total efficacy rate of bi-therapy and monotherapy was 92% vs. 71% （P 〈 0.05 ）. The negative conversion rate of HBeAg was 59% and 34% , respectively （P 〈 0.05 ）. The patients experienced less virus symbols after the treatment than before the treatment（P 〈 0.01 ）. The patients receiving the mono-therapy showed significant improvements of HA and LN levels（P 〈 0.01 ） but non-significant difference of PCⅢ and Ⅳ-C（P 〈0.01 ） after the treatment. Conclusion： Combination of interferon α1b with matrine offered synergistic effects against the liver fibrosis in CHB.