阿德福韦酯联合安络化纤丸对乙型肝炎早中期肝硬化治疗效果评价

Curative effect of adefovir dipivoxil combined with Anluohuaxian pill on hepatitis B cirrhosis

[目的]评价阿德福韦酯(ADV)联合安络化纤丸治疗乙型肝炎早中期肝硬化的疗效。[方法]145例乙型肝炎早中期肝硬化患者分为对照组(32例)、ADV组(53例)及联合用药组(60例)。对照组采用常规护肝及对症治疗;ADV组在对照组基础上加口服ADV 10mg,1次/d;联合用药组在ADV组基础上加口服安络化纤丸3g,疗程均为1年。比较3组治疗后肝功能、血清肝纤维化指标、乙型肝炎病毒(HBV)-DNA水平、Child-Pugh分值及门静脉压力指标变化。[结果]3组患者治疗后肝功能均不同程度的改善,联合用药组和ADV组肝功能改善优于对照组;联合用药组与ADV组血清白蛋白、球蛋白比较差异有统计学意义(P<0.01);联合用药组和ADV组肝纤维化指标、HBV-DNA水平和Child-Pugh分值较对照组明显下降,联合用药组肝纤维化指标下降优于ADV组,联合用药组Child-Pugh分值(5.02±0.76)明显低于ADV组(5.49±1.13),P<0.01;治疗后联合用药组门静脉内径、脾静脉内径及脾脏厚度较对照组和ADV组明显下降,ADV组脾脏厚度缩小(P<0.05)。[结论]ADV联合安络化纤丸在改善乙型肝炎早中期肝硬化患者肝功能,降低其Child-Pugh评分、肝纤维化指标、门静脉压力指标及HBV-DNA水平均有较好的效果。

[Objective]To evaluate the efficacy of adefovir dipivoxil combined with anluohuaxJan pill for early or mid-term cirrhosis due to chronic hepatitis B. [Methods]The total of 145 patients with early or mid-term hepatitis B cirrhosis were divided into control group（n=32）, adefovir dipivoxil（ADV） group（n = 53） and combination group（n = 60）. The control group was given conventional liver-protection and symptomatic treatment, the ADV group was given ADV 10mg once a day orally on the basis of conventional treatment,the combination group was given anluohuaxian pills 6 g three times a day orally on the basis of the ADV group. The course of treatment was one year. Liver function, serum liver fibrosis indices, HBV DNA levels, Child-Pugh score and portal pressure parameters of the 3 groups were compared 6 and 12 months after the treatment. [Results]The liver function of the 3 groups improved with various degree. The combination group and ADV group were more effective in improving liver function than the control group. There was statistically significant difference in albumin（ALB）, globulin（GLO）between the combination group and ADV group 12 months after the treatment（P〈0.01）. The liver fibrosis indices, HBVDNA levels and Child-Pugh scores of the combination group and ADV group decreased more significantly than those of the control group after the treatment. The liver fibrosis indices of combi- nation group were lower than those of ADV group. The Child-Pugh score （5.02 ± 0. 76） of the combination group was significantly lower than that （5.49±1.13） of ADV group 12 months after the treatment（P〈0.01）. The portal vein diameter, splenic vein diameter and spleen thickness of the combination group were significantly lower than those of ADV group and the control group. The spleen thickness of ADV group reduced after the treatment（P〈0.05）. [Conclusion] Adefovir dipivoxil combined with Anluohuaxian pill had good effect in improving liver function and reducing Child-Pugh score,liver fibrosis,portal vein pressure indicators and HBV-DNA level of early or mid-term hepatitis B cirrhosis.