Effects of combination therapy of matrine with adefovir dipivoxil on hepatic fibrosis in patients with chronic hepatitis B
-
摘要: 目的探讨苦参素联合阿德福韦酯(ADV)对慢性乙型肝炎(CHB)患者肝纤维化指标的影响。方法 116例CHB患者随机分为A组38例,给予苦参素胶囊0.2 g,3次/d,口服;B组38例,给予ADV 10 mg/d,C组40例,给予苦参素和ADV联合治疗,疗程均为48周。观察各组患者肝功能、血清HBV DNA、肝纤维化指标和B超门静脉主干内径、脾脏厚度,药物不良反应。结果 C组患者ALT复常率与A组比较差异有统计学意义(P<0.05),在治疗36周后HBV DNA转阴率高于A组和B组,差异均有统计学意义(P<0.05)。C组与B组患者治疗24周后,A组治疗36周后血清PCⅢ、CⅣ、LN、HA水平较治疗前明显下降(P<0.05);在治疗48周时C组与A组血清PCⅢ、CⅣ、HA水平比较,差异有统计学意义(P<0.05)。C组24、48周时脾脏缩小,与治疗前比较差异有统计学意义(P<0.05)。C组和B组共有5例患者出现轻度不良反应,但均能耐受。结论 ADV联合苦参素治疗肝纤维化疗效优于单用苦参素或ADV治疗。Abstract: Objective To study on the influence of combination therapy of matrine with adefovir dipivovir (ADV) on hepatic fibrosis level resulting from chronic hepatitis B.Methods Divide 116 patients with chronic hepatitis B into three groups at random.Group A:38 patients received matrine capsule (200mg po tid) ;Group B: 38 patients received 10 mg of ADV a day;group C: 40 patients received combine therapy of ADV and matrine.The course of treatment lasted for 48 weeks.During the treatment, liver function, HBV DNA in the serum, hepatic fibrosis level, internal diameter of portal vein trunk, splenic thickness and drug adverse reactions of patients in each group was checked.Results There was statistical difference of the ALT normalization between the patients in Group A and those in Group C (P<0.05) .After 36 weeks of treatment, the negativity rate of HBV DNA of the patients in group C was higher than those in group A and B (P<0.05) .After 24 weeks of treatment on patients in Group B and C and after 36 weeks in Group A, their PCⅢ, CⅣ, LN, HA levels in the serum declined dramatically compared with the ones prior to the treatment (P<0.05) ;at week 48, there was statistical differences between the PCⅢ, CⅣ, HA (except LN) levels in the serum of the patients in Group C and those in Group A (P<0.05) .At 24, 48 weeks, the spleen of the patients in Group C became smaller and existed statistical difference compared with the ones prior to the treatment (P<0.05) .Totally there were 5 patients in Group B and C appeared adverse drug reactions but all were tolerated.Conclusion Combination therapy of Marine with ADV was more effective than separate therapy of matrine or ADV, when treating for hepatic fibrosis.
-
Key words:
- hepatitis B /
- chronic /
- liver cirrhosis /
- antival agents /
- matrine
-
[1] 中华医学会.慢性乙型肝炎防治指南[J].中华肝脏病杂志, 2005, 13 (12) :881-891. [2]薛爱玲, 胡益民, 高宗玲.病毒性肝炎病人血清肝纤维化标志检测及其意义[J].中国基层医药, 2004, 11 (3) :453-454. [3]陆伦根, 曾民德.肝纤维化的非创伤性诊断和评估[J].中华肝脏病杂志, 2008, 16 (3) :165-168. [4]刘平.肝纤维化的防治[J].中华肝脏病杂志, 2000, 8 (3) :242. [5]蔺晓红, 斯崇文, 于岩岩, 等.阿德福韦酯治疗乙型肝炎e抗原阳性慢性乙型肝炎患者的临床研究[J].中华肝脏病杂志, 2006, 14 (12) :898-901. [6]郑卫东, 马晓军, 吴剑华, 等.苦参素注射液抗乙肝病毒疗效及与中医证型关系的临床研究[J].中西医结合肝病杂志, 2008, 18 (2) :77-79. [7]茅益民, 曾民德, 陆伦根, 等.氧化苦参碱胶囊治疗慢性病毒性肝炎肝纤维化的、随机、双盲、安慰剂对照多中心临床研究 (Ⅱ) [J].肝脏, 2002, 7 (4) :222-225. [8]杨清, 龚作炯, 胡丹凤.阿德福韦酯治疗乙型肝炎肝硬化失代偿期患者96周的临床观察[J].中华肝脏病杂志, 2009, 17 (7) :515-519.
本文二维码
计量
- 文章访问数: 3784
- HTML全文浏览量: 9
- PDF下载量: 761
- 被引次数: 0