扶正化瘀胶囊联合富马酸丙酚替诺福韦治疗慢性乙肝肝纤维化疗效观察

Efficacy of Fuzheng Huayu capsule combined with tenofovir fumarate in the treatment of patients with chronic hepatitis B fibrosis

目的探讨观察扶正化瘀胶囊联合富马酸丙酚替诺福韦治疗慢性乙肝肝纤维化的疗效及对患者免疫功能和炎症状态的影响。方法选取2020年3月至2021年3月衢州市人民医院收治的慢性乙肝肝纤维化患者150例,采用随机数字表法分为观察组75例与对照组75例。对照组患者给予富马酸丙酚替诺福韦治疗,观察组在对照组基础上联合扶正化瘀胶囊治疗,治疗疗程24周。比较两组患者临床疗效总有效率、治疗前与治疗24周肝功能相关指标(AST、ALT)、肝纤维化相关指标[透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PCⅢ)和Ⅳ型胶原(IV-C)]、免疫功能相关指标(CD3+、CD4+水平和CD4+/CD8+)、炎症因子(IL-6、IL-8和TNF-α)变化及不良反应发生情况。结果观察组患者总有效率明显高于对照组(P<0.05)。两组患者治疗24周AST和ALT水平均明显低于治疗前(均P<0.05),观察组又明显低于对照组(均P<0.01);HA、LN、PCⅢ和Ⅳ-C水平也均明显低于治疗前(均P<0.05),观察组又明显低于对照组(均P<0.01);而CD3+、CD4+水平和CD4+/CD8+均明显高于治疗前(均P<0.05),观察组又明显高于对照组(均P<0.01);IL-6、IL-8和TNF-α水平也均明显低于治疗前(均P<0.05),观察组又明显低于对照组(均P<0.01)。两组患者用药期间均未发生明显不良反应。结论扶正化瘀胶囊联合富马酸丙酚替诺福韦治疗慢性乙肝肝纤维化患者疗效良好,可提高患者免疫功能、减轻炎症状态,且安全性良好。

Objective To investigate the efficacy of Chinese medicine Fuzheng Huayu capsule combined with propofol tenofovir fumarate in the treatment of patients with chronic hepatitis B fibrosis and its effect on immune function and inflammation. Methods A total of 150 patients with chronic hepatitis B fibrosis admitted in Quzhou People’s Hospital from March 2020 to March 2021 were randomly divided into the study group and the control group with 75 cases in each group.Patients in the control group were treated with propofol tenofovir fumarate tablets, and those in the study group were treated with Fuzheng Huayu Capsule with propofol tenofovir fumarate tablets. The treatment course of the two groups was 24 weeks. The alanine aminotransferase(ALT), total bilirubin(TBIL) and aspartate aminotransferase(AST), hyaluronic acid(HA), laminin(LN), type Ⅲ procollagen(PC Ⅲ), type Ⅳ collagen(IV-C), and CD3;,CD4;, CD4;/CD8;, interleukin-6(IL-6), interleukin-8(IL-8) and tumor necrosis factor-α(TNF-α) were measured before and 24 weeks after treatment. The therapeutic effects were assessed, and the adverse reactions were observed. Results The overall effective rate in the study group was higher than that in the control group(90.67% vs. 77.33%, P<0.05). After 24 week-treatment, the AST, ALT, HA, LN, PC Ⅲ and Ⅳ-C levels in study group were lower than those in the control group(P<0.05). The CD3+, CD4+and CD4+/CD8+in study group were higher than those in the control group(P<0.05), while the IL-6, IL-8 and TNF-α levels were lower than those in the control group(P<0.05). No obvious adverse reactions were observed in both groups. Conclusion Chinese medicine Fuzheng Huayu Capsule combined with propofol tenofovir fumarate is effective and safe in the treatment of patients with chronic hepatitis B hepatitis B fibrosis,which can improve the immune function, reduce the inflammatory state of the patients as well.