拉米呋啶联用丹参治疗慢性乙型肝炎肝纤维化的疗效观察

The Efficacy of Combining Lamivudine with Salvia Miltiorrhiza on the Treatment of Chronic Hepatitis B Liver Fibrosis

目的 探讨拉米呋啶联用丹参治疗CHB肝纤维化的效应。方法 选择我院住院和门诊确诊为CHB以及肝纤维化血清学指标HA、PCⅢ、IV C和LN均升高的患者 1 2 5例 ,随机分为拉米呋啶 +丹参组 (Ⅰ组 ) 5 0例 ,单用拉米呋啶组 (Ⅱ组 ) ,丹参组 (Ⅲ组 )和对照组 (Ⅳ组 )各 2 5例。 4组的基本护肝治疗相同。拉米呋啶 1 0 0mg 1次 /d ;丹参片 4片 3次 /d ,对照组仅用基本护肝药 ,疗程为 1年。初治疗 3个月每 2w检查肝功能 ,HBV标志物、HBVDNA和HA、PCⅢ、Ⅳ C、LN 1次 ,以后每月检查 1次。结果 ALT复常率各治疗组均明显优于对照组 (P <0 0 5 ) ;Ⅰ组明显优于Ⅱ组、Ⅲ组 (P <0 0 5 ) ,Ⅱ组明显优于Ⅲ组 (P <0 0 5 ) ,Ⅲ组与Ⅳ组无显著性差异 (P >0 0 5 )。HBeAg/抗HBe转换率 ,Ⅰ、Ⅱ组分别是 36 %和 32 % ,无显著性差异 (P >0 0 5 ) ,Ⅲ组、Ⅳ组无转换者。肝纤维化血清检测 4项指标 ,各治疗组均明显优于对照组 (P <0 0 5 ) ,Ⅰ组明显优于Ⅱ、Ⅲ组 (P <0 0 5 ) ,Ⅱ、Ⅲ组无显著性差异(P >0 .0 5 )。结论 拉米呋啶联用丹参治疗CHB肝纤维化有协同作用。

Objective To investigate the therapeutic effect of combining Lamivudine with Salvia miltiorrhiza on the treatment of chronic hepatitis B (CHB) liver fibrosis. Methods Choice hospitalization for patients with the out patient for patients diagnostic marders chronec hepatitis B(CHB) and liver fibrosis the serum learn the based on the index of hyaluronic acid(HA), typeⅢ procollagen (PCⅢ), type Ⅳ collagen(Ⅳ C), and laminin (LN), 125 cases were selected from the hospitalized patients and out patients and divided into four groups treated with: lamivudine + Salvia miltiorrhiza (group Ⅰ, 50 patients), lamivudine (group Ⅱ, 25 patients), Salvia miltiorrhiza(group Ⅲ, 25 patients), and the control group(group Ⅳ, 25 patients). Basic liver protecting treatment was provided for all 4 groups of patients for 1 year, but for the treatment groups Lamivudine (100 mg q.d.) and salvia miltiorrhiza (4 Tab tid) were supplemented. Liver function, HBV markers,HBV DNA, HA, PCⅢ, Ⅳ C and LN were analyzed every 2 weeks in the first 3 months of treatment, and then analyzed every month. Results ALT retained normal in all the treatment group and was better than control( P <0.05).The retainion rate in group Ⅰ was obviously surpasses the better than group Ⅱ and Ⅲ( P <0 05), while group Ⅱ was better than group Ⅲ( P <0.05) and group Ⅱ and Ⅳ showed no significant different( P >0.05). HbeAg/anti Hbe sero conversion rate in group Ⅰ and Ⅱ were 36% and 32% respectively, and showed no liver ignificant difference ( P >0 05). Group Ⅲ and Ⅳ had no sero conversion. The 4 fibrosis serum index in all the treatment were better than control group ( P <0 05). Group I was better than Ⅱ and Ⅲ( P <0 05). Group Ⅱ and Ⅲ showed no obvious significant( P >0 05). Conclusion Lamivudine and Salvia miltiorrhiza showed a synergistic effect on the treatment of liver fibrosis. Treatment with both drugs was better than one and more effective than the control group.