苦参碱联合甘利欣注射液对慢性乙肝纤维化及血清TNF-α含量的影响

目的：观察苦参碱联合甘利欣注射液对慢性乙肝纤维化及血清TNF-α含量的影响。方法：将135例慢性乙型肝炎患者随机分为两组,治疗组72例采用苦参碱联合甘利欣注射液治疗,对照组64例采用拉米夫定治疗,6个月后观察两组患者肝功能、乙肝病毒标志物、肝纤4项以及肿瘤坏死因子α（TNF-α）含量的变化,并判断疗效。结果：与治疗前相比,两组均能显著降低血清丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、透明质酸（HA）、Ⅲ型前胶原肽（PCⅢ）、层粘连蛋白（LN）、IV型胶原（IV-C）以及TNF-α含量,提高白蛋白/球蛋白比值（A/G）（P〈0.01）;在降低ALT、AST、HA、PCⅢ、IV-c以及TNF-α含量方面,治疗组明显优于对照组（P〈0.05）;对照组Hbv-DNA阴转率高于治疗组（P〈0.05）,治疗组HbeAg阴转率优于对照组（P〈0.01）;治疗组临床总有效率88.9%,对照组临床总有效率75.0%,两组比较具有统计学差异（P〈0.05）。结论：苦参碱联合甘利欣注射液可降低血清TNF-α含量,抑制肝纤维化,同时还可抑制病毒复制,促进HBV复制标志物阴转,降低转氨酶,改善肝功能。

Effect of Sophocarpidine and Diammonium Glycyrrhizinate Injection on Hepatic Fibrosis and the Content of Tumor Necrosis Factor a of Chronicity Type B Hepatitis Patients

Objective：To observe the effect of sophocarpidine and diammonium glycyiThizinate injection on hepatic fibrosis and the content of tumor necrosis factor α（TNF -α） of chronicity type B hepatitis patients. Methods ： 135 cases patients with chronicity type B hepatitis were devided into two groups at random; The treatment group （ n = 72） were treated by sophocarpidine and diammonium glycyrrhizinate injection,and control group（n =64） were treated by Lamivudine tablet,with one treatment period of 6 months; Liver function,type B hepatovirus marker,hepatic fibrosis index and TNF-ctwere measured after treatment, and the curative effect were judgement. Results： Compared with before treatment, the content of alanine aminotransferase （ALT）, aspartate amino transferase （AST）, hyalumnic acid （HA）, precollagen Ill （ PC III） ,laminin（LN） ,collogen IV（ IV - c） and TNF - α in blood plasma were increased,and the ratio of albumin and globulin（A/G） were decreased obviously in two groups （P 〈 0.01 ） ; compared with control group, the ALT, AST, HA, PC III, IV- c and TNF-α were different obviously in treatment groups（ P 〈0.05 ）. The rate of Hbv- DNA negative in control group surpass treatment group（P 〈 0.05 ） ; The rate of HbeAg negative in treatment group surpass control groups （P 〈 0. 01 ） ;The effective rate of treatment group was 88.9%, which was higher than that of control group （75.0%, P 〈 0. 05 ）. Conclusion： sophocarpidine and diammonium glycyrrhizinate injection could decrease the content of TNF - ot and aminotransferase,restrain hepatic fibrosis and virus replication, improve the rate of Hbv - DNA negative and liver function.