苦参素联合钙离子拮抗剂治疗肝炎肝硬化疗效观察

目的观察苦参素联合钙离子拮抗剂治疗慢性乙肝后肝硬化对肝功能、肝脏血流动力学参数、血清肝纤维化指标等的影响。方法选择慢性乙肝肝硬化患者96例，Child—Pugh分级均为B级。随机分为治疗组56例和对照组40例。两组均给予苦参素（天晴复欣）600mg静脉滴注，1次／d（3个月）。治疗组在此基础上加用硝苯地平缓释片（伲福达）20mg／d，口服，2次／d（3个月）。比较两组患者的肝功能指标及血清肝纤维化指标并行肝脏B超测定肝门静脉血流动力学参数。结果3个月疗程结束后，治疗组上述指标明显改善。结论．苦参素联合硝苯地平缓释片治疗慢性肝炎肝硬化在保肝、抗肝脏纤维化、降低门脉高压方面比单用苦参素效果理想。

The Treatment Effect of Oxymatrine Combined With Calcium Channel Blocking Agent on Liver Cirrhosis after Hepatitis

Objective To evaluate the clinical effects and to explore the mechanism of action of oxymatrine combined with calcium channel blocking agent by observing the effect of oxymatrine combined with calcium channel blocking agent on liver function, liver hemodynamic parameters, serum liver fibrosis makers of the liver cirrhosis after chronic hepatitis B. Methods Selecting 96 patients of liver cirrhosis after chronic hepatitis B in our hospital, who were classified as Child-Pugh B grade. All the patients were divided into treatment group and control group randomly,and all of them were given intravenous plus oxymatrine 600mg （ once/day × 3 months ）. On this basis, treatment group were added oral nifedipine sustained release tablets 20mg （ twice/day × 3 months ）. To Compare liver function markers （ ALT, AST, TBIL, ALB, GLB ） and serum liver fibrosis markers （ HA, LN, IVC, PC 11） between the two groups, and then to determine the hemodynamic parameters of hepatic portal vein （ VPV, QPV and DPV ） by the examination of liver color doppler. Resuits The differences of efficiency beween the two groups were significant （ P 〈 0. 05 ）. Conclusion Oxymatrine combined with nifedipine sustained release tablets is more effective than single oxymatrine on protecting liver,anti-liver fibrosis and reducing portal hypertension,and it can improve the patients＇ symptom and sign and can improve liver function, delay or reverse the process of liver fibrosis, reduce portal hypertension and reduce the incidence of gastrointestinal bleeding, and then immprove the prognosis of patients.