氧化苦参碱治疗慢性丙型病毒性肝炎的初步研究

目的探讨氧化苦参碱治疗慢性丙型病毒性肝炎的效果及其机制。方法对43例慢性丙型肝炎病毒(HCV)感染患者随机分为治疗组(20例)和对照组(23例)。治疗组给予氧化苦参碱600mg,肌肉注射,1次/d,对照组给予维生素类一般护肝药物,疗程为3个月。结果治疗组可统计病例17例中血清HCV RNA转阴8例(47.1%)、对照组可统计病例18例中血清HCV RNA转阴1例(5.6%),两组转阴率比较差异有统计学意义,P<0.05。治疗组治疗第1、2个月末血清丙氨酸转氨酶(ALT)复常率均高于对照组(均为P<0.05),但治疗结束时两组复常率间差异无统计学意义。治疗组治疗血浆可溶性白介素-2受体(SIL-2R)水平和血清IV型胶原(IV-CL)水平较治疗前显著下降(分别为P<0.01、P<0.05),对照组治疗前后SIL-2R和IV-CL水平差异无统计学意义(均为P>0.05)。治疗组血浆SIL-2R水平和血清IV-CL水平下降值显著高于对照组(分别P<0.01,P<0.05)。结论氧化苦参碱有抑制HCV增殖,抗肝纤维化及调节宿主免疫反应的作用,可能成为治疗慢性HCV感染安全而有效的药物。

Preliminary stuty on therapeutic effect of oxymatrine in treating patients with chronic hepatitis C

Objective To evaluate the efficacy of oxymatrine in treating chronic hepatitis C and its mechanism.Methods Forty three patient were divided randomly into the treated group(20 cases)and the control group(23 cases).The treated gruop was given oxymatrine 600 my per day intramuscularly,and the control group was given the general liver protective agents such as vitamins.The therapeutic course of bot groups was 3 mouths.Results HCV RNA of 8 in 17 case(47.1%)of the treated group converted to negative,while in 18 cases of the control group,the negative conversion only took place in 1 patient(5.6%),the negative conversion rate was significantly higher in the treated group than that in the control group(P<0.05).The normalizaton rates of serum alanine transaminase(ALT)of the greated group after 1 month and 2 months treatment was higher than that of the control group,but after 3 months treatment,the normalization rates of the two groups were not different significantly.Plasma level of soluble interleukin-2 receptor and serum level of collagen type IV in the treated group were lowered significantly after treatment ,but in the control group,there were no significant change,the difference between the two groups was significant(P<0.01,P<0.05).Conclusion Oxymatrine is effective in inhibiting proliferation of HCV.an tagonisting liver fibrosis and regulating immune reaction of the host,so it could be a safe,effective durg in treating chronic hepatitis C.