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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HCV感染患者随机分为氧化苦参碱治疗组(20例)和一般护肝药物对照组(23例)。治疗组给予氧化苦参碱每日600毫克肌注,疗程三个月。结果:治疗组可统计病例17例,其血清HCV RNA转阴8例(47.1％),转阴率显著高于对照组可统计病例(18例),血清HCV RNA转阴1例(5.6％)(P<0.05)。治疗组第1、2月末血清丙氨酸转氨酶(ALT)复常率均高于对照组(各为P<0.05),但治疗结束时两组复常率间无显著差异。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<0.01,P<0.05),对照组在研究开始及结束时sIL-2R和Ⅳ-CL水平却无显著差异(均P>0.05)。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<0.01,P<0.05)。治疗组均有注射局部疼痛,但可忍受,1例出现皮肤瘙痒,未见其他不良反应。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。
Objective: To investigate the effect and mechanism of oxymatrine in the treatment of chronic hepatitis C virus. Methods: Forty-three patients with chronic HCV infection were randomly divided into oxymatrine treatment group (n = 20) and general liver protection drug control group (n = 23). The treatment group was given oxymatrine 600 mg daily intramuscularly, course of treatment for three months. Results: In the treatment group, 17 cases were statistically analyzed. Serum HCV RNA was negative in 8 cases (47.1%), the negative conversion rate was significantly higher than that in the control group (18 cases), serum HCV RNA negative in 1 case (5.6% (P <0.05). At the end of the first and the second month of treatment, the alanine aminotransferase (ALT) abnormalities in the treatment group were higher than those in the control group (all P <0.05), but there was no significant difference between the two groups at the end of treatment. After treatment, the levels of soluble interleukin-2 receptor (sIL-2R) and serum IV-CL in the treatment group decreased significantly (P <0.01 and P <0.05, respectively) There was no significant difference between the levels of sIL-2R and IV-CL at the end (all P> 0.05). Serum sIL-2R levels and serum IV-CL levels in treatment group were significantly lower than those in control group (P <0.01, P <0.05, respectively). The treatment group were injected with local pain, but can endure, skin pruritus occurred in 1 case, no other adverse reactions. Conclusion: Oxymatrine inhibits the proliferation of HCV, anti-hepatic fibrosis and regulates the host immune response, which may become a safe and effective drug for the treatment of chronic HCV infection.