苦参素合用拉米夫定治疗慢性乙型肝炎观察

目的观察苦参素联合拉米夫定治疗慢性乙型肝炎的疗效。方法83例慢性乙型肝炎患者,随机分为两组,治疗组45例苦参素静脉滴注,同时口服拉米夫定,对照组38例干扰素肌肉注射,同时口服拉米夫定,疗程均为6个月,随访半年,治疗各阶段测血清HBVDNA、乙肝标志物、ALT做为疗效观察指标。结果治疗结束时,治疗组血清HBVDNA阴转率88.9%、HBeAg阴转率57.8%,HBeAb血清转换率46.7%与对照组血清HBVDNA阴转率86.8%,HBeAb阴转率60.5%、HBeAb血清转换率47.4%相比无显著差别(P>0.05),半年随访治疗组HBVDNA阴转率77.8%、HBeAg阴转率53.3%、HBeAb血清转换率40.0%与对照组HBVDNA阴转率71.1%、HBeAg阴转率50%,HBeAb血清转换率39.5%相比(P>0.05),而ALT复常率明显高于对照组(P<0.05)。结论苦参素联合拉米夫定治疗慢性乙型肝炎协同作用好,特别是恢复肝功能效果显著。

Observation of Curative Effect of Combined Use of Coussein and Lamivadine in Treatment of Chronic Hepatitis

Objective To observe the curative effect of combined use of Coussein and Lamivadine on chonic hepatitis B.Methods 83 patients were divided into two groups at random,therapy group 45 patients received glucose saline with Coussein intravenously .In the control group, 38 patients were given injection of interferon,once a day ,15 days later twice a day.Both groups took 100mg Lamivadine orally ,a time a day for 6months.During the 6months at different stages serum HBVDNA were tested.Indicator of hepatitis B virus ALT was observed. Results At the end of treatment ,in therapy group , serum HBVDNA 88.9% patients was negative , 57.8% patients HBeAg became negative ,46.7% HBeAb serum exchange rate.There is little difference from that of the control group:86.8% serum HBVDNA became negative, 60.5% HBeAg became negative , 47.4% HBeAb serum exchange rate(P>0.05) . Half a year after the treatment ,there was no significant difference in the above indicator between the two groups , except that a much higher percentage of the ALT return normal in the therapy group than that in the control group(P<0.05) . Conclusion The combined use of the two medicines has certain curative effect . They are complementary in the treatment of chronic hepatitis B.