目的 观察安络化纤丸联合拉米夫定对慢性乙型肝炎患者肝功能、血清肝纤维化指标、细胞免疫功能的影响.方法 135例慢性乙肝患者随机分为两组,治疗组69例在保肝治疗的基础上再给予安络化纤丸6 g/次,3次/d,拉米夫定片100 mg,1次/d,疗程48周;对照组66例给予拉米夫定片100 mg,1次/d,疗程48周.两组治疗前后检测肝功能、肝纤维化指标及细胞免疫功能.结果治疗组治疗后血清透明质酸(HA)、层黏连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)较治疗前明显下降(P ＜ 0.05),且HA、PCⅢ的下降幅度明显优于对照组(P ＜ 0.05);治疗组治疗后丙氨酸氨基转移酶(ALT)、球蛋白明显降低(P ＜ 0.05);治疗组治疗后,外周CD4+T、CD4+T/CD8+T明显升高(P ＜ 0.05),CD8+T明显下降(P ＜ 0.05).结论安络化纤丸联合拉米夫定能够促进肝功能恢复,提高机体细胞免疫功能,改善血清肝纤维化指标,安全性与耐受性良好,疗效上显著优于对照组.%Objective To observe influence of liver function, serum fibrosis index, cellular immune function of chronic hepatitis B patients treated with Anluohuaxian Pills and Lamivudine. Methods 135 chronic hepatitis B patients were randomly divided into two groups. In 69 cases of treatment group, besides liver protection, patients were given Anluohuaxian Pills (6 g each time, 3 times per day) and Lamivudine (100 mg, once per day) in the total course of 48 weeks. In 66 cases of control group, participants were only offered Lamivudine (100 mg, once per day) in the total course of 48 weeks. Liver function, serum fibrosis index, and cellular immune function were tested before and after treatment. Results After the treatment, serum hyaluronic acid (HA), laminin (LN), precollagen Ⅲ (PC Ⅲ), collagen Ⅳ (Ⅳ-C), alanine aminotransferase (ALT), and globulin in the treatment group decreased remarkably compared with those before treatment (P < 0.05). Declining magnitude in HA and PC Ⅲ in treatment group were superior to those of control group (P < 0.05). In treatment group, after the therapy, CD4+T and CD4+T/CD8+T in peripheral blood increased obviously, while CD8+T was in a sharp decline (P < 0.05). Conclusion Anluohuaxian Pills combined with Lamivudine can promote recovery of liver function, improve cellular immune function, and better serum fibrosis index with a good safety and tolerance, whose effect is superior to that of control group.
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