阿德福韦酯联合苦参素治疗慢性乙型肝炎患者对肝纤维化指标的影响  

Effects of combination therapy of matrine with adefovir dipivoxil on hepatic fibrosis in patients with chronic hepatitis B

作　　者：赵文莉[1] 程红[1] 杨忠民[1] 

机构地区：[1]荆州市中心医院感染科,湖北荆州434020

出　　处：《临床肝胆病杂志》2011年第5期490-492,共3页Journal of Clinical Hepatology

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。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（P0.05）.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（P0.05）.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（P0.05）;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（P0.05）.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（P0.05）.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.

关 键 词：肝炎 乙型 慢性 肝硬化 抗病毒药 苦参碱 阿德福韦酯 

分 类 号：R512.62[医药卫生—内科学]