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目的探讨苦参素联合胸腺肽治疗慢性乙型肝炎的疗效,寻找治疗慢性乙型肝炎的有效方法。方法治疗组用苦参素葡萄糖注射液600mg,胸腺肽100mg,静脉注射,每日1次,使用12周后口服12周。对照组使用α干扰素500万U,皮下注射,隔日1次,胸腺肽100mg,肌肉注射,每周2次,用24周。两组患者均为乙型肝炎病毒单纯感染者。HB-sAg、HBeAg、HBcAb阳性,HBV DNA≥105拷贝/L。丙氨酸氨基转移酶(ALT)≥150U/L。结果治疗24周,苦参素组52例中39例(75.0%)ALT正常,干扰素组48例中38例(79.2%)ALT正常,差异无统计学意义(P>0.05)。苦参素组HBeAg、HBVDNA31例(59.6%)转阴。干扰素组HBsAg转阴1例(2.1%),HBeAg 27例转阴(56.2%),HBV DNA 29例转阴,占60.4%。两组病原学比较,差异无统计学意义(P>0.05)。停药随访12~24周,苦参素组31例近期治愈者18例(58.1%)复发,ALT升高,HBeAg和HBV DNA转阳。而干扰素组近期治愈的29例中10例(34.5%)ALT升高,HBeAg和HBV DNA转阳,χ2=1.09,P>0.05。远期疗效比较,差异无统计学意义(P>0.05)。结论苦参素与干扰素治疗慢性乙型肝炎,不论是近期还是远期疗效,差异均无统计学意义。在乙型肝炎的治疗中可以使用苦参素,但要延长疗程,和其他免疫调节剂联合使用,可能有增加疗效的作用。
Objective To investigate the efficacy of oxymatrine combined with thymosin in the treatment of chronic hepatitis B and find an effective way to treat chronic hepatitis B. Methods The treatment group with oxymatrine glucose injection 600mg, thymosin 100mg, intravenous injection once daily, after 12 weeks of oral administration of 12 weeks. The control group used interferon alpha 5 million U, subcutaneously, once every other day, thymosin 100 mg, intramuscularly, twice weekly for 24 weeks. Two groups of patients were hepatitis B virus infection alone. HB-sAg, HBeAg, HBcAb positive, HBV DNA ≥ 105 copies / L. Alanine aminotransferase (ALT)> 150 U / L. Results The ALT was normal in 39 cases (75.0%) of the 52 cases of oxytocin group and 38 cases (79.2%) of 48 cases in the interferon group. There was no significant difference in the ALT between the two groups (P> 0.05). Oxymatrine group of HBeAg, HBVDNA31 cases (59.6%) turned negative. Interferon group HBsAg negative in 1 case (2.1%), 27 cases of HBeAg negative (56.2%), HBV DNA 29 cases of negative, accounting for 60.4%. Etiology between the two groups, the difference was not statistically significant (P> 0.05). After stopping for 12 to 24 weeks, 18 patients (58.1%) in 31 patients who were treated by kushenin were relapsed with elevated ALT, HBeAg and HBV DNA. In 29 cases of interferon treated recently, 10 patients (34.5%) had elevated ALT, HBeAg and HBV DNA turned positive, χ2 = 1.09, P> 0.05. Long-term efficacy comparison, the difference was not statistically significant (P> 0.05). Conclusion Oxymatrine and interferon in the treatment of chronic hepatitis B, no matter short-term or long-term efficacy, the difference was not statistically significant. Oxymatrine can be used in the treatment of hepatitis B, but to prolong the course of treatment, in combination with other immunomodulators, may have the effect of increasing the efficacy.