苦参素胶囊联合阿德福韦酯治疗慢性乙型肝炎临床探究.docVIP

苦参素胶囊联合阿德福韦酯治疗慢性乙型肝炎临床探究 　 作者：刘兴峰，谭小芸，宁小艳， 陈星浩 【摘要】 目的：观察苦参素胶囊联合阿德福韦酯治疗慢性乙型肝炎的临床疗效。方法:34例HBeAg与HBV DNA均阳性的慢性乙肝患者接受苦参素胶囊联合阿德福韦酯治疗12个月并与30例单用阿德福韦酯治疗的患者进行对比。结果:疗程结束时观察组HBV-DNA阴转率为82.3%与对照组76.7% 相比无明显差异(Pgt;0.05)。观察组HBeAg阴转率为58.8% 明显高于对照组36.7% (Plt; 0.01)。疗程结束后随访6个月观察组HBeAg与HBV DNA持续阴转率为61.8%、85.4%明显高于对照组的33.3%、73.3% (Plt; 0.01)。观察组HBeAg与HBV DNA的复发率明显低于对照组(Plt; 0.05)。结论: 苦参素胶囊与阿德福韦酯联合应用有协同作用，可提高疗效，减少病毒耐药降低复发率。 【关键词】 慢性乙型肝炎; 苦参素胶囊; 阿德福韦酯 　　Clinical Evaluation on Marine Capsules Combined with the Adefovir Dipirovoxil for Chronic Hepatitis B 　　　Abstract: Objective：To observe the effect of matrine combined with Adefovir Dipirovoxil for chronic hepantis B. Method: Thirty four chronic hepatitisB patients were treated with matrine combined with Adefovir Dipirovoxil for 12 months and another 30 chronic hepatitisB patients were treated with Adefovir Dipirovoxil at same time. Result: HBV-DNA negative rate was 82.3% in observed group and 76.7% in control group respectively. No significant difference was found between two groups (Pgt;0. 05).A significant eleva-tion was found in the expression of HBeAg loss in observe group (P lt;0.01).Six-month follow }psurvery showed that the rate of sustained loss of both HBV-DNA and HBeAg was significantly greater in observe group than that in control group (61.8% vs 33.3%.85. 4% vs 73.3%，Plt;0.01).The recurrence rate of HBeAg and HBV-DNA was significantly lower in observed group than that in control group (Plt;0.05).Conclusion: Adefovir Dipirovoxil method can enhance the effect, reduce the number of virus of drug-resistant, and drop recurrence rate. 　　Key words: Chronic hepatitis B； Marine capsules; Adefovir dipirovoxil 　　苦参胶囊的主要成分是氧化苦参碱,有较强的抗HBV的作用。阿德福韦酯为新型的核苷类抗病毒药物,可抑制病毒复制。我们自2005年始应用苦参素胶囊联合阿德福韦酯治疗慢性乙肝,观察联合用药的疗效。现报道如下。 　　1 临床资料 　　1.1 研究对象: 　　为2005年1月至2006年1月我院门诊及住院的64例慢性乙肝患者。年龄16~65岁，男32例，女24例。均符合《2000年西安全国传染病与寄生虫病学术会议修订的病毒性肝炎防治方案》诊断标准。所有患者血清HBeAg, HBeAg, HBV-DNA均阳性，阳性持续6个月以上且排除丙型肝炎、丁型肝炎，无肝硬化和妊娠妇女。 12个月内未应用其他抗病毒药物。血清谷丙转氨酶(ALT)为正常值上限2~4倍;血清总胆