【摘要】目的 观察还原型谷胱甘肽联合苦参碱对慢性乙型肝炎的疗效。方法 将163 例慢性乙型肝炎患者随机分为两组,治疗组83 例给予苦参碱及还原型谷胱甘肽治疗;对照组80例单纯给予还原型谷胱甘肽。两组疗程均为8周。观察患者血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、碱性磷酸酶(ALP)、r谷氨酰转肽氨酶(rGT)、总胆红素(TBil)、透明质酸(HA)、层黏蛋白(LN)、IV 型胶原(IVC)、Ⅲ型胶原(PCⅢ) 及门静脉内径(D)值变化情况。结果 治疗组治疗后的ALT、AST、ALP、rGT、TBil、HA、LN、IVC、PCⅢ均降低,D 值变小,与治疗前比较有显著性差异( P<0.05)。与对照组治疗后比较,改善更明显,有非常显著性差异( P<0.01)。治疗组与对照组的总有效率分别为85.54% 和67.5%,差异有非常显著性( P<0.01)。结论 还原型谷胱甘肽联用苦参碱治疗慢性乙型肝炎,在降酶、退黄、抗肝纤维化、缩小D 值及改善临床症状方面有协同作用。 【关键词】 还原型谷胱甘肽;苦参碱;慢性乙型肝炎 Clinical Observation on the therapy of reduced glutathione Combined with Matrine in chronic hepatitis B QIN Houji,QIN Xueying,HE Yanzhuan (Affiliated Hospital of Youjiang Medical College for Nationalities, Baise Guangxi,533000) 【Abstract】 Objective To observe the curative effect of reduced glutathione combined with matrine in chronic hepatitis B.Methods 163 cases of chronic hepatitis B patients were randomly divided into two groups. 83 patients in treatment group were given reduced glutathione and matrine. 80 cases in control group were simply given reduced glutathione. Two groups were treated for eight weeks. The changes of serum alanine aminotransferase (ALT),aspartate aminotransferase (AST),alkaline phosphatase (ALP),rglutamyl transpeptidase in ammonia(rGT), total bilirubin (TBil ), hyaluronic acid (HA),laminin (LN), type IV collagen (IVC), collagen type Ⅲ (PC Ⅲ) and the portal vein diameter (D) were detected and observed.Results The serum level of ALT,AST,ALP,rGT, TBil,HA,LN,IVC,PC Ⅲ in treatment group were significantly decreased after 8 weeks treatment, and the D value was reduced too(P<0.01). Compare with the control group after treatment, there were significant differences (P<0.01). The efficiency of treatment group and the control group were 85.54% and 67.5%,that `s a significant difference (P<0.01).Conclusion The treatment of chronic hepatitis B combined reduced glutathione with matrine in reducing serum transaminase and serum bilirubin level, antiliver fibrosis,and narrowing the D value and improving the clinical symptoms have collaborative effect. 资料和方法 1.一般资料 本组慢性乙型肝炎患者163 例,均符合2000 年西安第十次全国病毒性肝炎及肝炎学术会议制订的《病毒性肝炎防治方案》诊断标准[1]。将病例随机分为两组,治疗组83 例,男70 例,女13 例;年龄18~64 (37.4 ±3.5) 岁;轻度慢性肝炎10 例,中度23 例,重度15 例,慢性重型肝炎15例,肝炎肝硬化20 例。对照组80 例,男69 例,女11 例;年龄17~64 (37.1±4.0)岁;轻度慢性肝炎11 例,中度22 例,重度14 例,慢性重型肝炎13 例,肝炎肝硬化20 例。两组性别、年龄、病程、病情等比较均无显著性差异(P>0.05),具有可比性。 1.肝功能指标 治疗组治疗后ALT、AST、ALP、rGT、TBil 明显下降,与治疗前比较有显著性差异(P<0.01),与对照组比较,也具有非常显著性差异(P<0.01),见表1 。 表1 两组治疗前后肝功能指标比较(略) 注: ①与同组治疗前比较,P<0.01;②与对照组治疗后比较,P<0.01。 表2 两组治疗前后肝纤维化指标比较(略) 注: ①与本组治疗前比较,P<0.01; ②与对照组治疗后比较,P<0.01。 表3 两组治疗前后D值变化比较(略) 注: ①与本组治疗前比较,t=10.592,P<0.01; ②与对照组治疗后比较,t=7.876,P<0.01。 表4 两组疗效比较(略) 注:与对照组比较,①:P<0.05 ; ②:P<0.01 讨论 慢性乙肝易发展至肝硬化,而肝纤维化是慢性肝病发展至肝硬化过程中必然的病理组织学变化,是影响慢性肝病预后的重要环节。在肝纤维化的早期给予有效治疗可减缓或防止发展至肝硬化。我国每年慢性乙肝演变为肝硬化高达14.2%[2],因而抗乙肝病毒及肝纤维化治疗无疑是最重要和有效的。肝活检虽是诊断肝纤维化的金标准,但因其创伤性和危险性而难以常规普及。血清肝纤维化指标和肝组织纤维化程度有良好相关性,并与肝组织纤维化发展的阶段性一致[3,4],故检测血清肝纤维化指标(LN、HA、PCⅢ、IVC)的含量可客观地推测/判断肝细胞损伤及纤维化程度。 【参考文献】 |
还原型谷胱甘肽联合苦参碱治疗慢性乙肝的临床观察简介:
【摘要】目的 观察还原型谷胱甘肽联合苦参碱对慢性乙型肝炎的疗效。方法 将163 例慢性乙型肝炎患者随机分为两组,治疗组83 例给予苦参碱及还原型谷胱甘肽治疗;对照组80例单纯给予还原型谷胱甘肽。两组 ... 责任编辑:admin |
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