苦参素联合α-干扰素对慢性乙型肝炎血清肝纤维化指标的影响

目的　探讨苦参素与α-干扰素联合应用对慢性乙型肝炎血清肝纤维化指标的影响。方法　将78例慢性乙型肝炎患者随机分为对照组、干扰素组、联合治疗组。三组均常规给予甘利欣、门冬氨酸钾镁等基础护肝治疗。干扰素组在基础护肝治疗同时,肌注重组α-2b干扰素,疗程6个月。联合治疗组在干扰素组基础上,肌注苦参素,疗程6个月。治疗前及治疗后定期检测肝功、血清HBV标志物,治疗前后各检测1次血清肝纤维化指标,包括透明质酸(HA)、层粘连蛋白(LN)、Ⅲ前胶原(PCⅢ)、IV型胶原(IV-CL)。结果　肝功复常率三组间比较无显著差异(P>0.05);干扰素组、联合治疗组HBeAg,HBV　DNA阴转率与对照组比较差异非常显著(P<0.01,P<0.001);对照组血清肝纤维化指标治疗前后比较无显著差异(P>0.05),干扰素组HA、PCⅢ治疗前后比较差异非常显著(P<0.001),联合治疗组HA,LN治疗后与干扰素组比较差异显著(P<0.05),联合治疗组PCⅢ治疗后与干扰素组比较差异非常显著(P<0.01)。结论　苦参素与α.干扰素两者合同,能起到互补和协同作用,提高抗病毒、抗纤维化效果。

The Effect of Oxymatrine Plus Interferon Alpha on the Levels of Serum Fibrosis Makers in Patients with Chronic Hepatitis B

Objective The present study was designed to investigate the effect of oxymatrine and α-IFN to the serum hepatic fibrosis makers of the chronic hepatitis B. Methods 78 patients with chronic hepatitis B were randomly divided into control croup IFN group and combined treatment group and each group was given the basic treatment such as diammonii glycyrrhizinatis, potassium magnesium aspartate to protect the hepar. As the same time the IFN group received recombined α-IFN intramuscular injection for 6 months, the combined treatment group received oxyrnatrine in for 6 months upon the rteatment of the IFN group. hepatic function and the serum hepatic fibrosis makers were detected before and after therapy, respectively. Moreover the serum hepatic fibrosis makers including hyaluronic acid ( HA ), laminin ( LN ), procollagen type III ( PCIII) and type IV collagen ( IV-CL ) were detected before and after treatment. Results To the rate of recovery of the hepatic function there was no significant difference among three groups.(P>0.05) To the rate of turning negative of HBeAG and HBV-DNA the IFN group enhanced greatly and compared with controls there significant difference (P<0.01). So did the combined treatment group(P<0.00l). In the control group the serum hepatic fibrosis makers was not changing much(P>0.05). While in the IFN group HA and PCIII after the thrapy was less than those before the therapy (P<0.001). After the treatment there was significant difference between HA and LN in the combined treatment group and those in the IFN group (P<0.05). So did PCIII in the two groups(P<0.01). Conclusion The combined treatment of oxymatrine and α-IFN could be synergistic and complementary to enhance the effect of antivirus and antifibrosis.