拉米夫定单独或联合苦参素治疗慢性乙型肝炎

The Effect of Lamivudine Alone or in Combination with Oxymatrine in the Treatment of Chronic Viral Hepatitis B

目的 :观察拉米夫定单独或联合苦参素治疗慢性乙型肝炎 (乙肝 )的疗效。方法 :慢性乙肝患者 76例分为A组 3 5例 (拉米夫定 10 0mg ,qd ,po ,连续 12个月 ) ,B组 2 1例 (拉米夫定服用方法及剂量同A组 ,同时口服苦参素胶囊2 0 0mg ,tid ,连续服 6个月 ) ,C组 2 0例 (常规护肝 ,对症治疗 ,未经抗病毒治疗作为对照 )。动态观察患者血清HBV复制指标和肝功能的变化。结果 :①A组HBV DNA阴转率在 3 ,6,12个月时分别为 62 .9% ,80 .0 % ,77.1% ;B组分别为 76.2 % ,90 .5 % ,76.2 %。A组HBeAg阴转率在 3 ,6,12个月时分别为 2 8.6% ,3 4.3 % ,42 .9% ;B组分别为 3 8.1% ,47.6% ,42 .9%。两组HBV DNA阴转率和HBeAg阴转率均显著高于C组 (P <0 .0 5 )。但两组之间比较差异无显著性 (P >0 .0 5 )。②A组丙氨酸氨基转移酶 (ALT)复常率在 3 ,6,12个月时分别为 3 7.1% ,65 .7% ,71.4% ;B组分别为 42 .9% ,66.7% ,81.0 %。两组ALT复常率与C组比较 ,仅在 12个月时差异有显著性 (P <0 .0 5 )。结论 :拉米夫定单用或与苦参素联用 ,均具有明显抑制乙肝病毒作用 ;拉米夫定与苦参素联用 ,有改善肝功能作用 ,且有提高HBV

Objective:To survey the therapeutic effect of lamivudine alone or in combination with oxymatrine in the treatment of chronic viral hepatitis B. Methods:76 patients with chronic viral hepatitis B were divided into 3 groups: A, B and C. Patients of group A ( n =35) were given each 100 mg of lamivudine PO, q.d. for 12 consecutive months. Patients of group B ( n =21) were subjected to lamivudine treatment as well at the same dosage as that of patients in group A. In the meantime, each of them was given 20 mg of oxymatrine PO, t.i.d.. The course of treatment lasted 6 months. Patients of group C (n=20) were treated with conventional hepatinica and symptomatic therapeutic measures, serving as controls. Changes in serum HBV replication markers and liver functions were dynamically monitored. Results:①At the end of the 3 rd , 6 th and 12 th months of treatment, the rates of sera to turn negative for HBV DNA were 62.9%, 80.0% and 77.1%, respectively, in patients of group A, and 76.2%, 90.5% and 76.2%, respectively, in patients of group B. In the same time series, the rates of sera to turn negative for HBeAg were 28.6,%.34.3% and 42.9%, respectively, in patients of group A, and 38.1%, 47.6% and 42.9%, respectively, in patients of group B. The rates of sera to turn negtive for HBV DNA and HBeAg, in patients of group A and group B were significantly higher than those in patients of group C( P <0.05). However, differences of these rates between patients of group A and group B were insignificant( P >0.05). ②At the end of the 3 rd , 6 th and 12 th months, the rates for serum ALT to be normalized were 37.1%, 65.7% and 71.4%, respectively, in patients of group A, and 42.9%, 66.7% and 81.0%, respectively, in patients of group B. At the end of the 12 th month only, the rates for serum ALT to be normalized in patients of group A and group B were significantly higher than that of patients in group C( P <0.05). Conclusion:Lamivudine alone or in combination with oxymatrine was shown to exert a definite inhibotory effect on hepatitis B virus. Administration of the two drugs in combination was capable of improving the liver function and increasing the rates for serum HBV DNA and HBeAg to turn negative.