肝乐胶囊对慢性乙型肝炎肝纤维化的疗效研究  

Therapeutic efficacy of Ganle capsule combined with lamivudine on liver fibrosis in chronic hepatitis B patients

作　　者：王国如[1] 曹正雨 

机构地区：[1]南京医科大学附属淮安第一医院,江苏淮安223300 [2]江苏省淮安市楚州医院药剂科,江苏淮安223200

出　　处：《中国现代医学杂志》2011年第13期1535-1538,1542,共5页China Journal of Modern Medicine

摘　　要：目的观察肝乐胶囊联合拉米夫定治疗慢性乙型肝炎肝纤维化的疗效,寻找克服拉米夫定耐药,提高乙型肝炎肝纤维化疗效的治疗方法。方法 136例患者平均分为两组,联合治疗组给予肝乐胶囊联合拉米夫定,并与单用拉米夫定比较,持续治疗48周。观察不同治疗时间点患者的病毒学、生物化学指标、血清肝纤维化指标等变化情况。其中血清肝纤维化指标包括:透明质酸(HA)、Ⅲ型前胶原氨端肽(PⅢ NP)、Ⅳ型胶原(IV-C)和层黏连蛋白(LN)。结果两组患者血清HBV DNA治疗后较治疗前显著下降;联合治疗组在48周时有92.6%的患者HBV DNA阴转;ALT、AST、HA、PⅢ NP、IV-C和LN等指标显著改善,并且优于单用拉米夫定组(P<0.01);治疗24和48周时,分别有25.0%和36.8%的患者出现了HBeAg血清学转换。治疗后24和48周,HBV DNA水平下降值、HBV DNA阴转率联合治疗均优于拉米夫定组(P<0.05)。结论肝乐胶囊联合拉米夫定能快速有效抑制慢性乙型肝炎的病毒复制,使HBV DNA水平下降,提高ALT复常率,显著改善肝功能、肝纤维化等指标。【Objective】 To explore the efficacy of Ganle capsule combined lamivudine treatment for liver fibrosis in chronic hepatitis B.【Methods】 136 patients were divided into two groups,68 each,the combination group given the Ganle capsule combined with lamivudine while the lamivudine gruop given lamivudine only,who were treated for 48 weeks.The changes in virological,biochemical indicators,virus resistance and serum liver fibrosis markers： hyalaronic acid（HA）,procollagen Ⅲ N-termi（PC-Ⅲ）,type IV collagen（IV-C） and laminin（LN） content were determined at a different time of treatment.【Results】 Marked serum HBV DNA decrease in both groups after treatment.For the combination treatment group,in the 48 th week,92.6% patients＇ HBV DNA converse negative,In the 24 th week,HBeAg seroconversion appear in 25.0% petients,and 36.8% in the 48th week.ALT,AST,HA,PC-III,IV-C and LN in all patients had obvious improvement（P 0.01）,and combination treatment group was more significant than lamivudine group.【Conclusions】 Ganle capsule combined with lamivudine can quickly and efficiently inhibit virus in liver fibrosis and chronic hepatitis B patients from replication,decline HBV DNA level,improve liver function and liver fibrosis indexes.

关 键 词：慢性 乙型肝炎 肝纤维化 拉米夫定 肝乐胶囊 

分 类 号：R512.62[医药卫生—内科学]