山莨菪碱辅助治疗慢性重症乙型肝炎的临床研究

目的 研究山莨菪碱辅助治疗慢性乙型重型肝炎的临床疗效.方法 将150例慢性乙型重型肝炎患者按抽签法随机分为对照组和治疗组,各75例.对照组入院后接受拉米夫定100 mg/d抗病毒治疗及给予常规护肝,同时强调基础治疗及积极补充鲜血浆、白蛋白等综合治疗,有并发症者给予相应处理,有条件者常规接受人工肝血浆置换治疗1～3次,治疗组在此治疗基础上加用山莨菪碱20 mg/d静脉滴注或分2次静脉注射,对比2组患者病死率以及治疗前和治疗后2、4及8周血清总胆红素(TBiL)、ALT、凝血酶原时间(PT)等血清学指标的变化.结果 治疗8周后对照组好转42例(56.0%),无效33例(44.0%),死亡30例(40.0%);治疗组好转54例(72.0%),无效21例(28.0%),死亡18例(24.0%).治疗组好转率优于对照组(x2=4.17,P=0.041),病死率低于对照组(x2=4.41,P=0.036).2组存活患者(治疗组57例,对照组45例)治疗后肝功能均逐渐恢复,但治疗组血清肝功能指标下降迅速.结论 山莨菪碱辅助治疗慢性重型乙型肝炎有助于快速恢复肝功能、减低病死率.

Abstract：

Objective To study the clinical efficacy of anisodamine as adjuvant therapy of chronic severe hepatitis B. Methods One hundred and fifty cases of chronic severe hepatitis B were randomly divided into control group (75cases) and treated group (75cases). The control group were given lamivudine 100 mg/d and conventional treatment. Meanwhile some patients accepted 1-3 times of the treatment of Plasma Exchange. Besides the treatment in control group,the treated group had anisodamine (20 mg every day by intravenous drip or injection 2 times every day). The mortality rate and the changes of serum (such as TBIL,ALT,etc)of two groups before treatment and two weeks,4 weeks,8 weeks after treatment were compared. Results The mortality rate of treatment group decreased significantly(18/75),compared with control group(30/75)(x2=4.41,P＜0.05). The liver function of survival cases in both two groups (57 cases of treatment group,45cases of control group)was restored gradually. But the serum indicators of liver function of the treatment group decreased more rapidly that those in control group at 2 weeks,4 weeks and 8 weeks after treatment(P＜0.01). Conclusion Anisodamine can restore the liver function and reduce mortality in the treatment of chronic severe hepatitis B.

The clinical research of anisodamine treatment of chronic severe hepatitis B

Objective To study the clinical efficacy of anisodamine as adjuvant therapy of chronic severe hepatitis B. Methods One hundred and fifty cases of chronic severe hepatitis B were randomly divided into control group (75cases) and treated group (75cases). The control group were given lamivudine 100 mg/d and conventional treatment. Meanwhile some patients accepted 1-3 times of the treatment of Plasma Exchange. Besides the treatment in control group,the treated group had anisodamine (20 mg every day by intravenous drip or injection 2 times every day). The mortality rate and the changes of serum (such as TBIL,ALT,etc)of two groups before treatment and two weeks,4 weeks,8 weeks after treatment were compared. Results The mortality rate of treatment group decreased significantly(18/75),compared with control group(30/75)(x2=4.41,P＜0.05). The liver function of survival cases in both two groups (57 cases of treatment group,45cases of control group)was restored gradually. But the serum indicators of liver function of the treatment group decreased more rapidly that those in control group at 2 weeks,4 weeks and 8 weeks after treatment(P＜0.01). Conclusion Anisodamine can restore the liver function and reduce mortality in the treatment of chronic severe hepatitis B.