拉米夫定、胸腺肽及苦参素联合应用.doc

拉米夫定、胸腺肽及苦参素联合应用 对慢性乙型病毒性肝炎的治疗作用 苍南县人民医院感染科 厉惠莉 325800 [摘要]目的 探讨拉米夫定、胸腺肽及苦参素联合应用对慢性乙型病毒性肝炎的治疗作用。方法 回顾性分析2006年12月至2008年12月我院收治的108例慢性乙型病毒性肝炎患者，随即分为治疗组和对照组，各54例，对照组给予拉米夫定100mg，每日1次，疗程12个月，胸腺肽40mg肌注，隔日一次，3个月后改为胸腺肽胶囊10mg口服，每日3次，连服9个月，治疗组在对照组的基础上加用苦参素胶囊0.2g，每日3次，连服12月。治疗前后检测肝功能、HBVDNA、HBeAg、HBsAg、抗-HBc及HBeAb。结果 治疗组的治愈率和显效率与对照组相比差异有统计学意义（P0.05）；治疗前后两组患者肝功能指标均有明显改善，治疗组指标变化较对照组明显(P0.05)；治疗组患者治疗前后HBVDNA、HBeAg阴转率、HBsAg转阴率、抗-HBc转阴率及HBeAb转阳率均明显高于对照组(p0.05)。结论 拉米夫定、胸腺肽联合苦参素有良好的协同抗病毒作用，可以更好的抑制病毒复制，促进HBV抗原血清学转阴。 [关键词]乙型病毒性肝炎；慢性；拉米夫定；胸腺肽；苦参素；治疗 The therapeutical effect of lamivudine and thymic peptide combined with kushenin to Chronic Hepatitis B [Abstract] Objective To investigate the therapeutical effect of lamivudine and thymic peptide combined with kushenin to Chronic Hepatitis B. Methods From December 2006 to December 2008，108 patients were enrolled and randomly divided into the study group(n=54) and the control group(n=54).The control group was given lamivudine 100mg，one time for 12 months orally taking as a period of treatment，given thymic peptide of 40 mildigram for muscle injection for one time every other day for 3 months as a period of treatment，and then 10mg，three times/days for 9 months orally taking as a period of treatment. On the foundation of control group，The study group was given keshenin 0.2g，three times/days for 12 months orally taking as a period of treatment. The ALT，AST，HBVDNA，HBeAg，HBsAg，HBeAb and anti-HBc were tested for two groups of patients before and after the treatment. Results The cure rate and excellence rate in the control group were significantly lower then the study group（P0.05）. The degrade degree of ALT，AST and TBIL in the study group were significantly lower then the control group（P0.05）. HBVDNA，HBeAg ，HBsAg，anti-HBc negative changing rate and HBeAb positive changing rate were higher than that of the control group(p0.05). Conclusion Lamivudine and thymic peptide combined with kushenin have a favourable cooperatively effect for anti-virus. The