苦参素治疗慢性乙型肝炎病毒低水平感染临床疗效

Clinical Effect of Marine Tablets in the Treatment of Chronic Hepatitis B Patients with Low Level of HBV

目的观察苦参素治疗慢性乙型肝炎病毒HBV DNA低水平(HBeAg阳性患者HBV DNA<20 000Iu/ml,HBeAg阴性患者HBV DNA<2 000 Iu/ml)感染的临床疗效。方法将72例慢性乙型肝炎病毒低水平感染患者随机分为治疗组(42例)和对照组(30例)。对照组给予联苯双酯滴丸7.5 mg,每日3次口服降转氨酶,疗程1个月;同时服用熊去氧胆酸片150 mg,每日2次消退黄疸,疗程1个月。1个月后继续服用维生素C片0.2 g,每日3次,疗程5个月作为对照。治疗组给予苦参素片0.2 g,每日3次,疗程6个月。两组患者分别于治疗后1个月、3个月、6个月复查肝功能、HBV DNA,观察其临床疗效并对临床有效率进行比较分析。结果在治疗1个月时,治疗组和对照组的ALT及TB复常率比较差异无统计学意义(P>0.05);两组病例在治疗1个月时,ALT及TB复常率与治疗前比较差异均有统计学意义(P<0.01)。两组病例在治疗1个月、3个月、6个月时,治疗组HBV DNA阴转率为11.9%、35.7%、57.1%,而对照组的阴转率为10.0%、13.3%、16.7%,两组间HBVDNA阴转率在治疗1个月时差异无统计学意义(P>0.05),在治疗3个月、6个月时差异有统计学意义(P<0.01)。组内比较:治疗组1个月、3个月、6个月时HBV DNA阴转率比较差异有统计学意义(P<0.01);对照组1个月、3个月、6个月时HBV DNA阴转率比较差异无统计学意义(P>0.05)。治疗组和对照组患者在治疗1个月时,临床症状及肝功能恢复情况差异均无统计学意义(P>0.05);两组与治疗前比较差异均有统计学意义(P<0.01)。两组总有效率比较差异有统计学意义(P<0.05)。结论苦参素具有抗病毒、抗炎、降酶、退黄作用,且疗效与时间呈正相关性。

Objective To evaluate the clinical effects of Marine Tablets in the treatment of chronic hepatitis B patients with low level of HBV virus loading（HBeAg positive patients＇ HBV DNA20 000 Iu / ml,HBeAg negative patients＇ HBV DNA2 000 Iu / ml）.Methods 72 patients were randomly divided into two groups,namely the treatment group（42 subjects）and the control group（30 subjects）.The patients in the control group received Bifendate pills 7.5mg PO thrice a day for 1 month in reducing enzyme（ALT）,at the same time received Ursodeoxycholic Acid Tablets 150mg PO twice a day for 1 month in jaundice elimination（TB）,and afterwards received Vitamin C Tablets 0.2g PO thrice a day for 5 months.Patients in the treatment group received Marine Tablets 0.2g PO thrice a day for 6 months.Liver function（ALT and TB） and HBV DNA were analyzed at the 1st,3rd and 6th month after the Marine Tablet treatment.Clinical effect and the clinical effective rates were compared and analysed.Results After 1 month of Marine Tablet treatment,ALT and TB normalization rate was similar in compares between the treatment and the control group（P0.05）.But compared to pretreatment,the difference in the level of ALT and TB normalization rate in both treatment and control group was significant（P0.01）.For the treatment group,the negative rate of HBV DNA at the 1st,3rd and 6th month was 11.9%,35.7% and 57.1%,respectively.The difference in the level of HBV DNA between the 3rd and 6th month was significant（P0.01）.While at the 1st month,the result was similar in compares（P0.05）.In the control group,the negative rate of HBV DNA in the 1st,3rd and 6th month was 10.0%,13.3% and