苦参素联合阿德福韦酯对乙型肝炎的疗效

Therapeutic Effect of Marine Combined with Adefovir Dipivoxil on Patients with Chronic Hepatitis B

目的:观察苦参素联合阿德福韦酯(ADV)治疗慢性乙型肝炎的临床疗效。方法:85例慢性乙型肝炎患者随机分为治疗组42例与ADV组43例,两组均应用阿德福韦酯片10mg/d,治疗组前24周同时给予苦参素胶囊200mg,po,tid。疗程48周。完成12周、24周和48周治疗时,检测血清HBV DNA水平、乙型肝炎病毒标志物及肝功能变化。结果:治疗组患者在治疗12周、24周和48周时HBV DNA阴转率为:19.0%、57.1%和66.7%高于ADV组的7.0%、34.9%和44.2%,两组比较差异有统计学意义(P<0.01)。在治疗12周和24周时HBeAg阴转率治疗组为:19.0%、35.7%亦高于ADV组的7.0%、16.3%,差异均有统计学意义(P<0.01)。治疗组总有效率在治疗结束时为:69.0%,高于ADV组同期的46.5%。差异有统计学意义(P<0.01)。结论:阿德福韦酯联合苦参素优于单用阿德福韦酯治疗慢性乙型肝炎。

Objective ： To observe the efficacy of marine combined with adefovir dipivovir（ADV） in treatment of the patients with chronic hepatitis B. Method： Eighty five patients with chronic hepatitis B were enrolled and randomly divided into two groups. The combined therapeutic group was 42 patients and the ADV control group was 43 patients. All patients in two groups were taken ADV 10 mg,po qd;Forty two patients in the treated group received marine capsule （200mg po rid） at the first 24 weeks. After 12 , 24 and 48- weeks of treatment, serum HBV DNA levels were measured by quantitative PCR and the changes of the liver function and the marker of HBV were analyzed. Result： The negative rate of HBV 19.0% ,57.1% and 66.7% were higher than those of the ADV group 7.0% , 34.9 and 44.2% at weekl2 , 24 and 48 respectively, P value was 〈 0.05. The serum negative rate of HBeAg of the treated group were 19.0% and 35.7% ,which were higher than those of the ADV group 7.0% and 16.3% at 12 and 24 weeks respectively; the total effect rates of the treated group （69.0%） were higher than of the ADV group （46.5%）, P 〈0.05. Conclusion： Marine combine with ADV are effective on the treatment of the patients with chronic hepatitis B and it is valuable to be used in clinic.