阿德福韦酯联合双虎清肝颗粒抗肝纤维化30例临床观察

Clinical efficacy of adefovir dipivoxil combined with Shuanghu Qingan granules in treatment of liver fibrosis: a report of 30 cases

目的:观察阿德福韦酯联合双虎清肝颗粒抗肝纤维化的临床疗效。方法:将60例慢性乙型肝炎患者随机分为治疗组与对照组各30例。治疗组予阿德福韦酯片联合双虎清肝颗粒治疗,对照组单予阿德福韦酯片治疗,疗程均为18个月。观察两组治疗前后症状与体征改善情况以及肝功能、肝纤维化4项等指标的变化情况。结果:总有效率治疗组为86.67%,对照组为53.33%,两组比较,差异有统计学意义(P<0.01);症状消失率治疗组为83.33%,对照组为63.33%、体征改善率治疗组为74.07%(20/27),对照组为46.15%(12/26),两组比较,差异均有统计学意义(P<0.05);治疗组肝功能和肝纤维化4项水平治疗前后组内比较,差异均有统计学意义(P<0.01),治疗组肝纤维化4项水平改善优于对照组,差异均有统计学意义(P<0.05);两组HBV-DNA水平均显著下降,治疗组下降幅度为(3.75±1.67)log10Copies/m L,对照组下降幅度为(3.23±1.89)log10Copies/m L,两组比较,差异无统计学意义(P>0.05);e抗原血清学转换率治疗组为36.67%,对照组为13.33%,两组比较,差异有统计学意义(P<0.01);两组肝脏炎症和纤维化程度较治疗前均有明显改善(P<0.01)。结论:阿德福韦酯联合双虎清肝颗粒能改善慢性乙型肝炎患者肝纤维化,值得临床推广。

Objective： To observe the clinical efficacy of adefovir dipivoxil combined with Shuanghu Qingan granules in the treatment of liver fibrosis. Methods： Sixty patients with chronic hepatitis B were randomly divided into treatment group（ n = 30） and control group（ n = 30）. The treatment group received adefovir dipivoxil combined with Shuanghu Qingan granules,while the control group received adefovir dipivoxil alone. The course of treatment was 18 months for both groups. The two groups were compared in terms of the improvements in symptoms,signs,liver function,and four liver fibrosis markers after treatment. Results： The treatment group had a significantly higher overall response rate than the control group（ 86. 67% vs 53. 33%,P 0. 01）. The symptom disappearance rate and sign improvement rate were significantly higher in the treatment group than in the control group（ 83. 33% vs 63. 33%,P 0. 05; 74. 07%（ 20 /27） vs 46. 15%（ 12 /26）,P 0. 05）. The treatment group showed significant improvements in liver function and levels of four liver fibrosis markers after treatment（ P 0. 01）,and the treatment group had significantly more improvements in the levels of four liver fibrosis markers than the control group（ P 0. 05）. Both groups showed significant decreases in HBV- DNA levels（（ 3. 75 ± 1. 67） log10 copies / ml vs（ 3. 23 ± 1. 89） log10 copies / ml,P 0. 05）. The treatment group had a significantly higher HBe Ag seroconversion rate than the control group（ 36. 67% vs13. 33%,P 0. 01）. Both groups showed significant improvements in the degrees of liver inflammation and fibrosis after treatment（ P 0. 01）. Conclusion： Adefovir dipivoxil combined with Shuanghu Qingan granules can reduce liver fibrosis in patients with chronic hepatitis B and holds promise for clinical application.