摘要 目的:观察苦参碱联合拉米夫定治疗慢性乙型病毒性肝炎的效果以及对肝纤维化指标的影响。方法:将慢性乙型病毒性肝炎患者88例,按随机数字表法分为2组,对照组和观察组各44例。2组均进行常规治疗,对照组给予拉米夫定片口服,观察组在此基础上联合使用苦参碱注射液静脉滴注治疗3个月,后给予苦参碱胶囊口服治疗9个月,2组疗程均为12个月。观察疗效并对比分析对肝纤维化指标的影响。结果:治疗后,对照组肝纤维化指标层粘连蛋白(LN)、透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)均下降,观察组肝纤维化指标LN、HA、PCⅢ、Ⅳ-C均下降且低于对照组(P<0.05)。治疗后,观察组谷丙转氨酶(ALT)恢复正常率、乙肝e抗原(HBeAg)转化率、HBV-DNA与HBeAg转阴率均高于对照组(P<0.05)。观察组总有效率高于对照组(χ2=4.768,P=0.029<0.05)。结论:采用苦参碱联合拉米夫定治疗慢性乙型病毒性肝炎患者,可有效降低肝纤维化程度,有利于恢复肝功能,治疗效果佳。 Objective:To observe the effect of matrine combined with lamivudine for chronic hepatitis B and its effect on liver fibrosis indexes. Methods:A total of 88 cases of patients with chronic hepatitis B were divided into the control group and the observation group according to the random number table method, 44 cases in each group. Both groups were given routine treatment. The control group was additionally given oral administration of lamivudine tablets;based on the treatment of the control group,the observation group was additionally given intravenous infusion of matrine injection for three months and oral administration of matrine capsules for nine months. Both groups were treated for 12 months. The curative effect was observed,and the effect on liver fibrosis indexes was compared and analyzed. Results:After treatment,the liver fibrosis indexes including laminin(LN), hyaluronic acid(HA), procollage Ⅲ(PC Ⅲ) and collagen Ⅳ( Ⅳ-C) in the control group were decreased,and the above indexes in the observation group were decreased and lower than those in the control group(P<0.05). After treatment, the recovery rate of alanine aminotransferase(ALT), the conversion rate of hepatitis B e antiagen(HBeAg),and the negative conversion rates of HBV-DNA and hepatitis B e antigen(HBeAg) in the observation group were all higher than those in the control group(P<0.05). The total effective rate in the observation group was higher than that in the control group(χ2=4.768,P=0.029<0.05). Conclusion:The therapy of matrine combined with lamivudine for chronic hepatitis B can effectively reduce liver fibrosis degree,which is conducive to the recovery of liver function with good curative effect.
机构地区 南阳市中心医院感染性疾病科 南阳市中心医院肝胆外科
出处 《新中医》 CAS 2021年第6期59-62,共4页 Journal of New Chinese Medicine
