强肝胶囊联合拉米夫定治疗慢性乙型肝炎肝纤维化的临床病理观察  

Clinical and Pathological Study on Effects of Qianggan Capsule Combined Lamivudine on Hepatic Fibrosis in Patients with Chronic Hepatitis B

作　　者：王华[1] 赵延龙[1] 徐克成[2] 杨柳明[1] 危北海[3] 张万岱[4] 陈杜芳[1] 

机构地区：[1]广东省廉江市人民医院,广东524400 [2]深圳养和医疗中心 [3]北京市中医研究所 [4]南方医科大学南方医院

出　　处：《中国中西医结合杂志》2006年第11期978-980,共3页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：广东省湛江市科技攻关项目(湛科〔2001〕86号)

摘　　要：目的探讨强肝胶囊联合拉米夫定治疗慢性乙型肝炎肝纤维化的疗效。方法85例患者随机分为两组,中西药组(40例)用强肝胶囊联合拉米夫定,中药组(45例)单用强肝胶囊,两组均治疗6个月。治疗前3个月内和治疗后1个月内分别进行血清肝纤维化指标和肝穿刺病理学检测。结果(1)血清肝纤维化指标:两组治疗后透明质酸、Ⅳ型胶原、层黏蛋白均显著下降(P<0·05)。(2)肝组织学改变:中西药组炎症活动度改善的总有效率为80·0%,肝纤维化改善总有效率为70·0%;中药组分别为57·8%和75·6%,中西药组治疗后炎症活动度改变程度优于中药组(P<0·05),但肝纤维化程度改变两组比较差异无显著性。结论强肝胶囊联合拉米夫定可明显减轻炎症坏死活动性,单纯强肝胶囊也能改善肝纤维化病变。Objective To study the therapeutic effects of Qianggan Capsule （QC） combined Lamivudine on hepatic fibrosis in patients with chronic hepatitis B. Methods Eighty-five patients were randomly divided into two groups, group A （40 cases） were treated with QC and Lamivudine and group B （45 cases） were treated with QC alone both for 6 months. Hepatic fibrosis related indexes and pathologic examination of liver biopsy were performed within 3 months before treatment and in 1 month after treatment, Results Serum levels of hyaluronic acid, collagen Ⅳ and laminin decreased markedly after treatment in both groups （P 〈 0.05）. Hepatic histopathological examination showed that the total effective rate of impovement in activity of inflammation- necrosis and fibrosis was 80.0% and 70.0% in group A, 57.8% and 75.6% in group B, respectively, the combined treatment showed a better effect in improving the activity of inflammation-necrosis than QC alone （P〈 0.05）, but with no significant difference to the latter in improving fibrosis, Conclusion QC combined Lamivudine could markedly reduce the activity of hepatic inflammation-necrosis, QC alone could also improve hepatic fibrosis.

关 键 词：强肝胶囊 拉米夫定 慢性乙型肝炎 肝纤维化 病理观察 

分 类 号：R512.62[医药卫生—内科学]