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目的:观察苦参碱联合甘利欣注射液对慢性乙肝纤维化及血清TNF-α含量的影响。方法:将135例慢性乙型肝炎患者随机分为两组,治疗组72例采用苦参碱联合甘利欣注射液治疗,对照组64例采用拉米夫定治疗,6个月后观察两组患者肝功能、乙肝病毒标志物、肝纤4项以及肿瘤坏死因子α(TNF-α)含量的变化,并判断疗效。结果:与治疗前相比,两组均能显著降低血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、透明质酸(HA)、Ⅲ型前胶原肽(PCⅢ)、层粘连蛋白(LN)、IV型胶原(IV-C)以及TNF-α含量,提高白蛋白/球蛋白比值(A/G)(P<0.01);在降低ALT、AST、HA、PCⅢ、IV-c以及TNF-α含量方面,治疗组明显优于对照组(P<0.05);对照组Hbv-DNA阴转率高于治疗组(P<0.05),治疗组HbeAg阴转率优于对照组(P<0.01);治疗组临床总有效率88.9%,对照组临床总有效率75.0%,两组比较具有统计学差异(P<0.05)。结论:苦参碱联合甘利欣注射液可降低血清TNF-α含量,抑制肝纤维化,同时还可抑制病毒复制,促进HBV复制标志物阴转,降低转氨酶,改善肝功能。
Objective: To observe the effects of matrine combined with salidroside on chronic hepatitis B and serum TNF-α content. Methods: One hundred and thirty-five patients with chronic hepatitis B were randomly divided into two groups. 72 cases in the treatment group were treated with matrine and salmeterol, 64 cases in the control group were treated with lamivudine. After 6 months, Liver function, hepatitis B virus markers, liver fibrosis 4 and tumor necrosis factor α (TNF-α) levels, and determine the efficacy. Results: Compared with those before treatment, the levels of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), hyaluronic acid (HA), procollagen Ⅲ (P <0.01). The levels of ALT, AST, HA and PCⅢ were significantly higher than those of control group (P <0.01) (P <0.05). The negative conversion rate of Hbv-DNA in the control group was higher than that in the treatment group (P <0.05), and the negative conversion rate of HbeAg in the treatment group was superior to that of the control group (P <0.01). The total clinical effective rate was 88.9% in the treatment group and 75.0% in the control group. The difference between the two groups was statistically significant (P <0.05). Conclusion: Matrine combined with Gan Lixin injection can reduce serum TNF-α content, inhibit liver fibrosis, but also inhibit viral replication, promote HBV replication markers negative conversion, reduce transaminase and improve liver function.