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目的:探讨泌胆剂对慢性乙型肝炎的辅助治疗作用。方法:158例慢性乙型肝炎患者随机分为泌胆剂组和对照组。对照组给予一般护肝治疗,泌胆剂组在一般护肝治疗基础上同时给予泌胆剂(加诺,3次/d,1~2片/次)治疗3月。两组病例如具备抗病毒治疗指针,则给予干扰素抗病毒治疗6个月。比较各组患者治疗中和治疗结束时的生化和/或病毒学指标。结果:和对照组相比,泌胆剂组患者血清ALT、AST和TBil治疗后下降幅度均较大。其中,在非抗病毒患者,泌胆剂组治疗1月和3月时的AST及TBil水平、治疗3月时ALT水平显著低于对照组;在抗病毒治疗患者,泌胆剂组治疗1、3、6月时的TBil水平及治疗1、6月时AST水平与对照组比较差异有显著意义。在抗病毒治疗的患者,泌胆剂组病毒应答指标(包括治疗3和6月时的HBVDNA阴转率、e系统血清学转换率)以及ALT复常率较高,但未达统计学意义水平。结论:泌胆剂作为慢性乙型肝炎患者的辅助治疗,能改善患者肝功能生化指标。是否增强慢性乙型肝炎干扰素抗病毒疗效有待进一步研究。
Objective: To explore the adjuvant treatment of chronic hepatitis B with urinary bile. Methods: 158 patients with chronic hepatitis B were divided into two groups randomly: the cholecystitis group and the control group. The control group was treated with general liver protection, and the group of secretory gallbladder was given concurrent treatment with cholecystokinin (Gannon, 3 times / d, 1 ~ 2 tablets / time) on the basis of general liver protection treatment for 3 months. Two groups of patients with anti-viral therapy pointer, then given interferon antiviral therapy for 6 months. Biochemical and / or virological indicators at the end of treatment and at the end of treatment were compared between groups. Results: Compared with the control group, serum ALT, AST and TBil decreased significantly in the patients of the bile-compaction group. Among them, the levels of AST and TBil in January and March in the non-antiviral group and the secretory group were significantly lower than those in the control group at 3 months of treatment; in the antiviral group, The levels of TBil at 3 and 6 months and AST levels at 1 and 6 months after treatment were significantly different from those in the control group. In patients with antiviral therapy, the indicators of viral response in the group of genitourinary agents (including HBVDNA negative conversion rate at 3 and 6 months, serological conversion rate of the e-system) and the rate of ALT normalization were high but not statistically significant . Conclusion: As a adjuvant therapy for chronic hepatitis B patients, it can improve the biochemical indexes of liver function in patients. Whether to enhance the efficacy of chronic hepatitis B interferon antiviral remains to be further studied.