阿德福韦酯联合安络化纤丸治疗慢性乙型肝炎的疗效

The therapeutic effect of Anluohuaxian capsule combined with adefovir dipivoxil on patients with chronic hepatitis B and influence on hepatic histology

目的观察阿德福韦酯（ADV）联合安络化纤丸治疗慢性乙型肝炎患者的临床疗效。方法治疗组36例采用ADV联合安络化纤丸治疗，对照组36例单用ADV治疗，治疗48周后，观察治疗前后的肝功能、肝纤维化指标、HBVDNA及肝组织学。统计学分析采用t检验或χ2检验。结果治疗48周后，治疗组和对照组患者在肝功能、血清纤维化标志物及肝脏组织学均有改善，治疗后两组患者在ALT、AST、总胆红素、白蛋白、肝组织炎症活动度积分和HBVDNA阴转率方面比较，差异无统计学意义。治疗组和对照组患者治疗后血清肝纤维化标志物透明质酸（HA）值分别为（101．58±30．11）μg／L、（182．25±117．59）μg／L；层黏连蛋白（LN）值分别为（147．89土41．72）μg／L、（181．50±56．96）μg／L；IV型胶原蛋白（CW）值分别为（38．75±9．50）μg／L、（74．92±31．14）μg／L，治疗组患者的HA、LN、CIV值与对照组比较，f值分别为3．987、2．856、6．666，P值均〈0．05，差异均有统计学意义。治疗组治疗前后肝组织纤维化积分分别为12．28±3．16、10．61±2．37，治疗前后比较，f=2．532，（P〈0．05，差异有统计学意义；对照组治疗前后肝组织纤维化积分分别为12．17±3．01、11．36±2．93，治疗前后比较，t=1．151，P〉0．05，差异无统计学意义。结论ADV联合安络化纤丸治疗慢性乙型肝炎患者具有良好的抗肝纤维化作用，患者获得明显肝组织学改善。

Objective To observe the efficacy of adefovir dipivoxil（ADV） in combination with Anluohuaxian capsule in the treatment of chronic hepatitis B （CHB） patients. Methods 72 cases with CHB were randomly divided into two groups. 36 cases of treatment group were given ADV combined with Anluohuaxian capsule for 48 weeks. 36 cases of control group were given ADV. The levels of serum ALT, AST, Alb, TBil, HA, LN, C IV, HBV DNA and hepatic tissue were compared before and after being treated. Results After 48 weeks treatment,the liver fimction, serum fibrosis index and histology of treatment group and control group all have improved. After treatment, the two groups in the levels ofALT（t = 0.746, P = 0.342）, AST（t = 0.369, P = 0.713）, TBil （t = 0.146, P = 0.684）, Alb（t = 0.148, P = 0.883）, liver tissue inflammation mobility scoring （t = 1.666, P = 0.100） and HBV DNA negative rate （x2 = 0.141, P = 0.708） were no evident difference.The level of HA, LN, C IV were significantly lower in treatment group（101.58 ± 30.11, 147.89 ± 41.72, 38.75 ± 9.50） compared with control group（182.25 ± 117.59, 181.50 ± 56.96, 74.92 ± 31.14） （P〈 0.05）. After the treatment, the liver tissue fibrosis scoring was significantly lower in treatment group （10.61 ± 2.37） compared with before the treatment （12.28 ± 3.16） （P 〈 0.05）.There was no difference found between afterthe treatment （11.36 a= 2.93） and before the treatment （12.17 ± 3.01） in control group （P 〉 0.05）. Conclusions The results show that the treatment with ADV in combination with Anluohuaxian capsule can play promoting antifibrotic effect and significant improved liver histology of chronic hepatitis B patients.