替比夫定联合扶正化瘀片治疗慢性乙型肝炎肝纤维化60例疗效观察

Therapeutic effect of telbivudine combined with Fuzheng Huayu tablets in treatment of liver fibrosis in chronic hepatitis B: a report of 60 cases

目的探讨替比夫定片联合扶正化瘀片治疗慢性乙型肝炎肝纤维化的疗效。方法选择本院2011年7月至2012年11月收治的慢性乙型肝炎(CHB)患者120名,随机分为2组,治疗组与对照组各60例。治疗组和对照组常规应用替比夫定片抗病毒及护肝等治疗;治疗组在上述治疗同时,联合应用扶正化瘀片治疗6个月。观测肝功能、肝纤维化四项指标、患者的症状体征等变化。计数资料采用χ2检验,计量资料采用t检验。结果经过6个月治疗,治疗组AST(33.1±15.5 vs 39.5±18.4)、白蛋白/球蛋白比例(A/G)(1.78±0.41 vs 1.64±0.32)、TBil(13.8±6.6 vs 17.9±8.3)复常,ALT(55.3±23.4 vs 64.7±27.6)降低,与对照组比较差异皆有统计学意义(t值分别为2.060、2.085、3.172、2.012,P值均<0.05);治疗组血清透明质酸(HA)(107.7±82.3 vs141.6±91.4)、层黏连蛋白(LN)(125.4±73.2 vs 154.9±76.5)、Ⅲ型前胶原(PⅢP)(0.61±0.56 vs 0.96±0.44)、Ⅵ型胶原(Ⅳ-C)(90.6±78.3 vs 134.3±67.9)有较大程度改善,与对照组比较差异均有统计学意义(t值分别为2.155、2.135、3.266、3.807,P值均<0.05);治疗组患者疲乏感减轻(71.7%vs 53.3%)、食欲增加(83.3%vs 65.0%)、腹胀减轻(80.0%vs 58.3%),与对照组比较差异皆有统计学意义(P<0.05)。结论 CHB患者存在着不同程度肝纤维化,应用替比夫定片联合扶正化瘀片治疗,患者在症状改善、肝功能恢复及肝纤维化改善方面明显优于单用替比夫定。

ObjectiveTo investigate the therapeutic effect of telbivudine combined with Fuzheng Huayu tablets in the treatment of liver fibrosis in chronic hepatitis B （CHB）. MethodsA total of 120 patients with CHB, who were admitted to our hospital from July 2011 to November 2012, were randomly divided into treatment group （n=60） and control group （n=60）. All patients received antiviral and liver-protecting therapy with telbivudine; meanwhile, the treatment group was given Fuzheng Huayu tablets as an addition for 6 months. The liver function, four indices for liver fibrosis, and patient′s symptoms and signs were evaluated. The enumeration data were analyzed by chi-square test, and the measurement data were analyzed by t-test. ResultsAfter 6 months of treatment, the treatment group showed normalized aspartate aminotransferase （AST）, albumin/globulin ratio （A/G）, and total bilirubin （TBil） as well as decreased alanine aminotransferase （ALT）, and there were significant differences between the treatment group and control group in AST （33.1±15.5 vs 39.5±18.4, t=2.060, P〈0.05）, A/G （1.78±0.41 vs 1.64±0.32, t=2.085, P〈0.05）, TBil （13.8±6.6 vs 17.9±8.3, t=3.172, P〈005）, and ALT （55.3±23.4 vs 64.7±27.6, t=2.012, P〈005）; also, the treatment group showed significant improvements in hyaluronic acid （HA）, laminin （LN）, type Ⅲ procollagen peptide （PⅢP）, and type Ⅳ collagen （Ⅳ-C）, and there were significant differences between the treatment group and control group in HA （1077±82.3 vs 141.6±91.4, t=2.155, P〈0.05）, LN （125.4±73.2 vs 154.9±76.5, t=2.135, P〈0.05）, PⅢP （0.61±0.56 vs 096±0.44, t=3.266, P〈0.05）, and IV-C （90.6±78.3 vs 134.3±67.9, t=3.807, P〈0.05）. In addition, the treatment group had alleviated lassitude, improved appetite, and palliated abdominal distension, demonstrating significant differences compared with the control group （71.7% vs 53.3%, P〈0.05; 83.3% vs 65.0%, P〈0.05; 80.0% vs 58.3%, P〈0.05）. ConclusionWhen used along with Fuzheng Huayu tablets, telbivudine has better performances in relieving symptoms, improving liver function, and reducing liver fibrosis in CHB patients with liver fibrosis.