异甘草酸镁联合拉米夫定治疗慢性乙型肝炎的疗效观察

Curative effect of magnesium isoglycyrrhizinate in combination with lamivudine on chronic hepatitis B

目的观察异甘草酸镁联合拉米夫定治疗慢性乙型肝炎的临床疗效。方法将78例慢性乙肝患者随机分成治疗组和对照组,治疗组(39例)口服拉米夫定100 mg,每天一次,同时用异甘草酸镁注射液200 mg静脉滴注,每天一次;对照组(39例)口服拉米夫定100 mg,每天1次。疗程均为8周。观察治疗前后总胆红素(T-Bil)、丙氨酸氨基转移酶(ALT)、天冬氨酸转氨酶(AST)、乙肝病原学血清标志物、肝纤维化指标变化情况。结果治疗结束后,两组肝功能均有明显改善;治疗组HBeAg阴转率,HBVDNA阴转率,抗HBe阳转率均明显高于对照组(P<0.01);治疗组血清透明质酸(HA)、Ⅲ型前胶原肽(PCⅢ)、Ⅳ型胶原(C-Ⅳ)和层黏蛋白(LN)浓度明显下降(P<0.05)。结论异甘草酸镁与拉米夫定联合治疗可以促进肝功能恢复,提高抗病毒和增强抗纤维化效果。

Aim To investigate curative effect of magnesium isoglycyrrhizinate in combination with lamivudine on chronic hepatitis B. Methods The combination group（ n = 39） was treated with the union of magnesium isoglycyrrhizinate （ injection ,400 mg, iv gtt qd ） and lamivudine （ tabs, 100 mg, po, qd） for 8 consecutive weeks. The control group （ n = 39 ） was treated with lamivudine only, following the same direction and course. Alanine aminotransferase （ALT） , aspartate aminotransferase （AST） and total bilirubin （ TB ）, markers of HBV and the liver fibrosis indexes were tested before and after the tretment. Results After the treatment,levels of ALT, AST and TB decreased in both groups, but there was no significant difference between two groups. There were significant differences in the negative-turning rate of HBeAg and HBVDNA, HBeAg/anti-seroconversion rate, in the levels of HA, PC Ⅲ, C- and LN between the two groups. Conclusion The magnesium isoglycyrrhizinate in combination with lamivudine chronic hepatitis B was helpful to promote the liver function recovery, anti-hepatitis B virus activities and anti-hepatic fibrosis effect when treating.