安络化纤丸联合干扰素α-1b治疗慢性乙型肝炎肝纤维化疗效观察

摘要

Objective To investigate the efficacy of Anliwhuaxianwan and interferon α-1b combination therapy on liver fibrosis in patients with chronic hepatitis B (CHB). Methods Totally 129 CHB patients with liver fibrosis were randomly divided into 3 groups, including Anluohuaxianwan group (AL group) (40 cases), interferon a-lb (IFN group) (49 cases), and AL+IFN group (46 cases). The levels of serum fibrosis markers (PC HI, HA, C W and LN) were detected through radioimmunoassay (RIA) at week 0, 24 and 48 of treatment and week 24 after drug withdrawal. The symptoms, liver function, serological markers of HBV, HBV DNA titer and the imaging change under color Doppler were monitored, and pathologic change was also detected in 3 patients of each group undergoing biopsy. Results The total efficiency of AL group, IFN group and AL+IFN group were 70.0%, 72.0% and 91.3%, respectively, at week 48 of treatment, and 75.0%, 74.4% and 86.9%, respectively, at week 24 after withdrawal, and that of AL+IFN group was significantly higher than those of the other two groups (P<0.05). The levels of PC III, HA, C IV and LN in AL+IFN group decreased significantly after treatment (P<0.05), and compared with AL group and IFN group, they decreased significantly after treatment and during follow-up (P<0.05). At week 48 of treatment and week 24 after drug withdrawal, the negative seroconversion rates of HBeAg and HBV DNA in AL+IFN group were higher than those in AL group (P<0.05), while no differences were found between AL+IFN group and IFN group. Conclusions The combination of Anluohuaxianwan and interferon a-lb has better effect on anti-fibrosis, anti-virus and improvement in liver function, which helps inhibit the progression of CHB.%目的 观察安络化纤丸联合干扰素(interferon,IFN)α-1b(运德素)治疗慢性乙型肝炎(乙肝)肝纤维化的疗效.方法 将129例慢性乙肝肝纤维化患者随机分为安络化纤丸组(AL组)40例、IFN α-1b组(IFN组)43例和安络化纤丸联合IFN α-1b组(AL+IFN组)46例.3组患者在治疗0、24、48周及停药24周时采用放射免疫分析法检测血清肝纤维化指标水平,同时观察患者临床症状,监测肝功能、乙肝标志物、HBV DNA滴度和肝脏影像学变化等指标,对各治疗组(每组3例)患者进行肝脏活体组织检查,观察肝脏病理变化.结果 AL组、IFN组、AL+IFN组3组比较,治疗48周时总有效率分别为70.0％、72.0％、91.3％;停药24周随访时总有效率分别为75.0％、74.4％、86.9％,AL+IFN组优于AL组和IFN组(P均＜0.05).AL+IFN组治疗后PCⅢ、HA、CⅣ、LN水平较治疗前显著下降(P均＜0.05);AL+IFN组与AL组、IFN组治疗后及随访时比较,PCⅢ、HA、CⅣ、LN水平也降低明显(P均＜0.05).在治疗48周时、停药24周时,AL+IFN组HBeAg阴转率和HBV DNA阴转率高于AL组(P均＜0.05).AL+ IFN组与IFN组同期比较,差异无统计学意义.结论 安络化纤丸联合IFNα-1b较安络化纤丸单用具有更好的抗肝纤维化、抗病毒和改善肝功能的作用,可能更有利于阻断慢性乙肝的发展.