强肝胶囊联合拉米夫定治疗慢性乙型肝炎肝纤维化的临床病理观察

目的 探讨强肝胶囊联合拉米夫定治疗慢性乙型肝炎肝纤维化的疗效。方法 85例患者随机分为两组，中西药组（40例）用强肝胶囊联合拉米夫定，中药组（45例）单用强肝胶囊，两组均治疗6个月。治疗前3个月内和治疗后1个月内分别进行血清肝纤维化指标和肝穿刺病理学检测。结果 （1）血清肝纤维化指标：两组治疗后透明质酸、Ⅳ型胶原、层黏蛋白均显著下降（P〈0．05）。（2）肝组织学改变：中西药组炎症活动度改善的总有效率为80．0％，肝纤维化改善总有效率为70．0％；中药组分别为57．8％和75．6％，中西药组治疗后炎症活动度改变程度优于中药组（P〈0．05），但肝纤维化程度改变两组比较差异无显著性。结论 强肝胶囊联合拉米夫定可明显减轻炎症坏死活动性，单纯强肝胶囊也能改善肝纤维化病变。

Clinical and Pathological Study on Effects of Qianggan Capsule Combined Lamivudine on Hepatic Fibrosis in Patients with Chronic Hepatitis B

OBJECTIVE: To study the therapeutic effects of Qianggan Capsule (QC) combined Lamivudine on hepatic fibrosis in patients with chronic hepatitis B. METHODS: Eighty-five patients were randomly divided into two groups, group A (40 cases) were treated with QC and Lamivudine and group B (45 cases) were treated with QC alone both for 6 months. Hepatic fibrosis related indexes and pathologic examination of liver biopsy were performed within 3 months before treatment and in 1 month after treatment. RESULTS: Serum levels of hyaluronic acid, collagen N and laminin decreased markedly after treatment in both groups (P < 0.05). Hepatic histopathological examination showed that the total effective rate of impovement in activity of inflammation-necrosis and fibrosis was 80.0% and 70.0% in group A, 57.8% and 75.6% in group B, respectively, the combined treatment showed a better effect in improving the activity of inflammation-necrosis than QC alone (P < 0.05), but with no significant difference to the latter in improving fibrosis. CONCLUSION: QC combined Lamivudine could markedly reduce the activity of hepatic inflammation-necrosis, QC alone could also improve hepatic fibrosis.