还原型谷胱甘肽联合苦参碱治疗慢性乙肝的临床观察

Clinical Observation on the therapy of reduced glutathione Combined with Matrine in chronic hepatitis B

目的观察还原型谷胱甘肽联合苦参碱对慢性乙型肝炎的疗效。方法将163例慢性乙型肝炎患者随机分为两组,治疗组83例给予苦参碱及还原型谷胱甘肽治疗;对照组80例单纯给予还原型谷胱甘肽。两组疗程均为8周。观察患者血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、碱性磷酸酶(ALP)、r-谷氨酰转肽氨酶(r-GT)、总胆红素(TBil)、透明质酸(HA)、层黏蛋白(LN)I、V型胶原(IV-C)、Ⅲ型胶原(PCⅢ)及门静脉内径(D)值变化情况。结果治疗组治疗后的ALT、AST、ALPr、-GT、TBil、HA、LN、IV-C、PCⅢ均降低,D值变小,与治疗前比较有显著性差异(P<0.05)。与对照组治疗后比较,改善更明显,有非常显著性差异(P<0.01)。治疗组与对照组的总有效率分别为85.54%和67.5%,差异有非常显著性(P<0.01)。结论还原型谷胱甘肽联用苦参碱治疗慢性乙型肝炎,在降酶、退黄、抗肝纤维化、缩小D值及改善临床症状方面有协同作用。

Objective To observe the curative effect of reduced glutathione combined with matrine in chronic hepatitis B. Methods 163 cases of chronic hepatitis B patients were randomly divided into two groups. 83 patients in treatment group were given reduced glutathione and matrine. 80 cases in control group were simply given reduced glutathione. Two groups were treated for eight weeks. The changes of serum alanine aminotransferase （ALT） ,aspartate aminotransferase （AST）, alkaline phosphatase （ALP）, r-glutamyl transpeptidase in ammonia-（r-GT）, total billrubin （TBil）, hyaluronic acid （HA） ,laminin （LN）, type Ⅳ collagen （Ⅳ-C）, collagen type Ⅲ （PC Ⅲ ） and the portal vein diameter （D） were detected and observed. Results The serum level of ALT,AST,ALP,r-GT, TBil,HA,LN,Ⅳ-C, PC Ⅲ in treatment group were significantly decreased after 8 weeks treatment, and the D value was reduced too（ P 〈 0.01）. Compare with the control group after treatment, there were significant differences （ P 〈0.01）. The efficiency of treatment group and the control group were 85.54% and 67.5% ,that ＇s a significant difference （ P〈0.01）. Conclusion The treatment of chronic hepatitis B combined reduced glutathione with matrine in reducing serum transarninase and serum bilirubin level, anti-liver fibrosis,and narrowing the D value and improving the clinical symptoms have collaborative effect.