阿德福韦酯联合柔肝化纤颗粒治疗慢性乙型肝炎肝硬化临床效果

Clinical effect of Adefovir Dipivoxil combined with Rougan Huaxian Granules on chronic hepatitis B cirrhosis

目的 观察阿德福韦酯联合柔肝化纤颗粒治疗慢性乙型肝炎病毒(HBV)肝硬化患者的临床效果。方法 选取2017年3月~2019年3月广西中医药大学第一附属医院确诊为慢性乙型肝炎肝硬化患者100例,按随机数字表法将其分为对照组和治疗组,每组50例。对照组采用单纯阿德福韦酯治疗,治疗组在对照组的基础上加用柔肝化纤颗粒治疗,共治疗6个月。观察两组患者治疗前后临床症状、肝功能、肝纤维化4项、肝脏B超及HBVDNA、乙型肝炎e抗原(HBeAg)和乙型肝炎e抗体(HBeAb)的含量。结果 两组患者治疗后中医证候积分均优于治疗前,且治疗组优于同期对照组(P <0.05);治疗后两组肝功能指标[天冬氨酸氨基转移酶(AST)、谷丙转氨酶(ALT)、总胆红素(TBIL)]、肝纤维化指标[血清透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原肽(PCⅢ)、4型胶原(Ⅳ-C)]、门静脉内径、脾脏厚度均较治疗前显著下降(均P <0.05),且与对照组比较,治疗组下降程度更为明显(P <0.05);治疗后,治疗组HBV-DNA阴转率、HBeAg阴转率、HBeAg/HBeAb血清转换测定值均高于对照组,但两组比较差异无统计学意义(P> 0.05)。结论 阿德福韦酯联合柔肝化纤颗粒治疗慢性乙型肝炎肝硬化比单用阿德福韦酯疗效更显著,值得临床推广。

Objective To observe the clinical efficacy of Adefovir Dipivoxil combined with Rougan Huaxian Granules in the treatment of patients with chronic hepatitis B virus(HBV)cirrhosis.Methods From March 2017 to March 2019,100 patients with chronic hepatitis B cirrhosis diagnosed by The First Affiliated Hospital of Guangxi University of Chinese Medicine were selected.According to the random number table method,they were divided into the control group and the treatment group,with 50 patients in each group.The control group was treated with Adefovir Dipivoxil alone,and the treatment group was treated with Rougan Huaxian Granules on the basis of the control group for a total of 6 months.The clinical symptoms,liver function,liver fibrosis 4 items,liver B-mode ultrasound,the content of HBV-DNA,hepatitis B e antigen(HBeAg)and hepatitis B e antibody(HBeAb)in the two groups were observed before and after treatment.Results The traditional Chinese medicine syndrome scores of patients in both groups after treatment were better than those before treatment,and the treatment group was better than the control group at the same period(P<0.05).In the two groups after treatment liver function index[aspartic transaminase(AST),alanine transaminase(ALT),total bilirubin(HBIL)],liver fibrosis index[serum hyaluronic acid(HA),laminin(LN),typeⅢprocollagen(PCⅢ),typeⅣcollagen(Ⅳ-C)],portal vein diameter,the thickness of the spleen decreased significantly before the treatment(all P<0.05),and compared with the control group,the degree of the treatment group decreased more significantly(P<0.05).After treatment,HBV-DNA negative conversion rate,HBeAg negative conversion rate and HBeAg/HBeAb serum conversion in the treatment group were all higher than those in the control group, but the difference between the two groups was not statistically significant (P > 0.05). Conclusion Adefovir Dipivoxil combined with Rougan Huaxian Granules in the treatment of chronic hepatitis B cirrhosis is more effective than Adefovir Dipivoxil alone, which is worthy of clinical promotion.