苦参素注射液联合促肝细胞生长素治疗慢性乙型重型肝炎的疗效

目的探讨苦参素注射液(Oxymarine,OM)联合促肝细胞生长素(pHGF)治疗慢性乙型重型肝炎(CSHB)的临床价值。方法慢性乙型重型肝炎37例,随机分为治疗组22例,对照组15例,两组均给予综合基础治疗,治疗组22例再加用抗病毒药物OM 600mg,肌注,1次/d,联合pHGF200～300mg+10％GS250～500ml中,静滴,1次/d,存活者坚持3个月一疗程。结果治疗组和对照组的病死率分别为36.4％(8/22)和73.3％(11/15),P<0.01;在CSHB早、中期二组病死率分别为10％与57.1％和42.9％与80％,P<0.01,而晚期二组病死率为75％与100％,P>0.05;二组治疗后HBsAg均无改变,而HBeAg和HBV DNA在治疗组的阴转率为71.4％(10/14)和64.3％(9/14),而对照组分别为 25％(1/4)和0(0/4),P<0.01。结论OM联合pHGF治疗CSHB,通过抑制乙型肝炎病毒复制、促进肝细胞生长、阻断肝细胞凋亡等作用,可降低病死率,安全无副反应。

Treatment of chronic severe hepatitis B with oxymarine injectio combined with promoting hepatocyte growth factor

To observe the clinic therapeutic effects of Qxymarine (OM) combined with promoting hepato-cyte growth factor (pHGF) on chronic severe hepatitis B(CSHB). Methods 37 cases with CSHB were randomly divided into tow groups: 22 cases of treated group and 15 cases of controlled group. They all were treated by comprehensive basic therapy. Treated group was again added to OM 600mg i. m. plus pHGF 200- 300mg + 10% GS 250 - 500ml i. v gtt once a day for three months. Results Mortality of treated and controlled group was 36. 4% (8. 22) and 73. 3(11/15). respectively, P < 0.01; In the early and middle stage of CSHB, the mortality of two groups was 10 %, 57.1% and 42. 9%, 80%, respectively, P<0.01, but in the latter stage, the mortality of two groups was 75% and 100%, respectively, P >0. 05; After treatment, while the HBsAg of two groups was still positive, the negative rate of HBeAg and HBV - DNA in two groups was 71.4%(10/14), 64.3% (9/14) and 25%(1/4), 0(0/4), respectively, by statistiscal process, there is a significant difference (P<0.01) between the two groups. Conclusion In the synthesis treatment, adding to OM combined with pHGF for CSHB, inhibiting viral replication, promoting hepatic growth, obstrucing hepatic apoptosis, can decrease the mortality and was well tolerated.