氧化苦参碱治疗慢性丙型病毒性肝炎的初步研究

作者	单位
李继强	Li Jiqiang, Li Chaoqun ,Zeng Mingde, et al Renji Hospital of Shanghai Second Medical University, Shanghai (200001
李超群	Li Jiqiang, Li Chaoqun ,Zeng Mingde, et al Renji Hospital of Shanghai Second Medical University, Shanghai (200001
曾民德	Li Jiqiang, Li Chaoqun ,Zeng Mingde, et al Renji Hospital of Shanghai Second Medical University, Shanghai (200001
佘祥奎	Li Jiqiang, Li Chaoqun ,Zeng Mingde, et al Renji Hospital of Shanghai Second Medical University, Shanghai (200001
李国钦	Li Jiqiang, Li Chaoqun ,Zeng Mingde, et al Renji Hospital of Shanghai Second Medical University, Shanghai (200001
范建高	Li Jiqiang, Li Chaoqun ,Zeng Mingde, et al Renji Hospital of Shanghai Second Medical University, Shanghai (200001
华静	Li Jiqiang, Li Chaoqun ,Zeng Mingde, et al Renji Hospital of Shanghai Second Medical University, Shanghai (200001
邱德凯	Li Jiqiang, Li Chaoqun ,Zeng Mingde, et al Renji Hospital of Shanghai Second Medical University, Shanghai (200001
萧树东	Li Jiqiang, Li Chaoqun ,Zeng Mingde, et al Renji Hospital of Shanghai Second Medical University, Shanghai (200001

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中文摘要:

目的 :初步探讨氧化苦参碱治疗慢性丙型病毒性肝炎的效果及其机制。方法 :43例慢性丙型肝炎病毒(HCV)感染患者随机分为治疗组 (2 0例 )和对照组 (2 3例 )。治疗组给予氧化苦参碱每日 60 0mg肌肉注射 ,对照组给予维生素类一般护肝药物 ,疗程均为 3个月。结果 :治疗组可统计病例 1 7例中血清HCVRNA转阴 8例(47 1 % )、对照组可统计病例 1 8例中血清HCVRNA转阴 1例(5 6% ) ,两组转阴率比较有显著性差异 (P <0 0 5 )。治疗组治疗第 1、2个月末血清丙氨酸转氨酶(ALT)复常率均高于对照组(均为P <0 0 5 ) ,但治疗结束时两组复常率间无显著性差异。治疗组治疗后血浆可溶性白介素 2受体(SIL 2R)水平和血清IV型胶原(IV CL)水平较治疗前显著下降(分别为P <0 0 1、P <0 0 5 ) ,对照组治疗前后SIL 2R和IV CL水平无显著性差异 (均为P >0 0 5 )。治疗组血浆SIL 2R水平和血清IV CL水平下降值显著高于对照组 (分别P <0 0 1 ,P <0 0 5 )。结论 :氧化苦参碱有抑制HCV增殖 ,抗肝纤维化及调节宿主免疫反应的作用 ,可能成为治疗慢性HCV感染安全而有效的药物。

英文摘要:

Objective: To evaluate the efficacy of oxymatrine in treating chronic hepatitis C and its mechanism. Methods: Forty three patient were divided randomly into the treated group (20 cases) and the control group (23 cases). The treated group was given oxymatrine 600 mg per day intramuscularly, and the control group was given the general liver protective agents such as vitamins. The therapeutic course of both groups was 3 months. Results: HCVRNA of 8 in 17 cases (47 1%) of the treated group converted to negative, while in 18 cases of the control group, the negative conversion only took place in 1 patient (5.6%), the negative conversion rate was significantly higher in the treated group than that in the control group (P<0 05). The normalization rates of serum alanine transaminase (ALT) of the treated group after 1 month and 2 months treatment was higher than that of the control group, but after 3 months treatment, the normalization rates of the two groups were not different significantly. Plasma level of soluble interleukin 2 receptor and serum level of collagen type Ⅳ in the treated group were lowered significantly after treatment, but in the control group, there were no significant change, the difference between the two groups was significant (P<0 01,P<0 05). Conclusion: Oxymatrine is effective in inhibiting proliferation of HCV, antagonisting liver fibrosis and regulating immune reaction of the host, so it could be a safe, effective durg in treating chronic hepatitis C.

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