氧化苦参碱联合拉米呋定治疗慢性乙型肝炎

Treatment of Chronic Hepatitis B with Oxymatrine Injection in Combination with Lamivudine

目的 :观察氧化苦参碱联合拉米呋定治疗慢性乙型肝炎 (乙肝 )的临床疗效。方法 :将慢性乙肝患者 80例随机分成治疗组和对照组各 40例 ,治疗组给予氧化苦参碱注射液 40 0mg ,im ,qd ,拉米呋定 10 0mg ,po ,qd ;对照组单用拉米呋定 10 0mg ,po ,qd。两组疗程均 12～ 2 4周。观察治疗前后肝功能、乙肝病原学血清标志物、肝纤维化指标变化情况。结果 :两组肝功能均有较明显的改善 ;治疗组和对照组HBV DNA转阴率分别为 90 .0 % ,85 .0 % ;HBeAg转阴率分别为 47.5 % ,2 7.5 % ;肝纤维化指标血清透明质酸 (HA)、Ⅲ型前胶原肽 (PⅢP)、Ⅳ型胶原 (C Ⅳ )和层黏蛋白 (LN)浓度明显下降。与治疗前相比 ,两组差异均有显著性 (P <0 .0 5 ) ;治疗组在HBeAg转阴率、HA、C Ⅳ的改善方面均优于对照组 (P <0 .0 5 )。结论 :氧化苦参碱联合拉米呋定治疗慢性乙肝能有效改善肝功能 ,抗病毒方面有协同作用 。

Objective:To survey the effect of oxymatrine injection combined with lamivudine in the treatment of chronic hepatitis B.Methods:80 patients with chronic hepatitis B(CHB) were randomly divided into two equal groups. Patients of the treatment group were given each 400 mg of oxymatrine injection, I.M. q.d. and 100 mg of lamivudine, PO q.d. while those of the control group were given each 100 mg of lamivudine, PO q.d. alone. The course of treatment in both groups lasted 12～24 weeks. Changes in liver function, serum markers of HBV and indices of hepatic fibrosis before and after the treatment were kept under observation. Results:Liver function of patients in both groups was found to improve dramatically. The rates of serum turning negative for HBV DNA were 90.0% and 85.0% in the treatment group and control group, respectively( P >0.05). The rates of serum turning negative for HBeAg, however, were 47.5% and 27.5% in the treatment group and control group, respectively( P <0.05). lndices of hepatic fibrosis including serum concelntrations of hyalurorhic acid(HA), procollagen type Ⅲ(PCⅢ), collagen type Ⅳ(CⅣ) and laminin(LN) were markedly lowered. The differences were significant in both groups when compared with those parameters before the treatmnet( P <0.05). Serum levels of HA and C Ⅳ were lower in the treatment group than in the control group( P <0.05) after the treatment. Conclusion:Oxymatrine injection combined with lamivudine was found to improve liver function, exert synergistic antiviral effect and promote the process of antifibrosis in the treatment of chronic hepatitis B.