阿德福韦酯联合大黄廑虫丸治疗乙型病毒性肝炎失代偿期肝硬化疗效观察

Combined adefovir dipivoxil and Rhubarb Zhechong pill for treatment of hepatitis B decompensated cirrhosis

目的观察阿德福韦酯联合大黄鹰虫丸治疗乙型病毒性肝炎（乙肝）失代偿期肝硬化的疗效。方法将61例乙肝失代偿期肝硬化患者完全随机分为治疗组（31例）和对照组（30例）。2组均采用内科综合性常规治疗，治疗组加用阿德福韦酯和大黄廑虫丸口服，疗程1年。观察并比较2组治疗前后的症状、体征和肝功能、肝纤维化指标变化及乙肝病毒脱氧核糖核酸（HBV-DNA）阴转率。结果治疗组总有效率为93．5％（29／31），对照组总有效率为80．0％（24／30），治疗组疗效高于对照组（P〈0．05）。治疗组在治疗后丙氨酸转氨酶（ALT）、总胆红素（TBIL）、血清透明质酸（HA）、血清层黏连蛋白（LN）、Ⅲ型前胶原（PCⅢ）较治疗前明显改善，差异有统计学意义（P〈0．01或P〈0．05）；且ALT、HA、LN、PCⅢ的下降优于对照组，差异有统计学意义（P〈0．01或P〈0．05）。治疗组的HBV—DNA阴转率为87．9％（27／31），优于对照组的13．5％（4／30）（P〈0．01）。2组治疗均未发现明显药物不良反应。结论阿德福韦酯联合大黄唐虫丸治疗能够通过有效抑制病毒和抗纤维化明显改善乙肝失代偿期肝硬化。

Objective To observe the efficacy of combined adefovir dipivoxil and Rhubarb Zhechong pill for treatment of hepatitis B decompensated cirrhosis. Methods Sixty-one cases of hepatitis B decompensated cirrhosis patients were randomly divided into two groups. The treatment group was treated with adefovir dipivoxil and rhubarb Zhechong pill, plus conventional medical treatment. All treatments were continued for one year. Symptoms, liver function, hepatic fibrosis changes and the HBV-DNA negative rate before and after treatment were observed. Results The efficiency rate in treatment group was 93.5%, higher than that in control group （80.0%） （ P 〈 0.05）. ALT,TBIL,HA,LN,PC Ⅲ in treatment group were significantly lower （P 〈 0.01 or P 〈 0.05 ） after therapy. Meanwhile the decrease of ALT, HA, LN, PC Ⅲ after therapy were higher than that in control group （ P 〈 0.01 or P 〈0.05 ）. The HBV-DNA negative rate in treatment group was 87.9%, higher than that of control group（ 13.5% ） （P 〈0.01 ）. Conclusion Combined Adefovir dipivoxil and rhubarb Zhechong pill can improve the prognosis in hepatitis B decompensated cirrhosis patients.