替诺福韦联合安络化纤丸治疗乙肝肝硬化代偿期的疗效

Clinical efficacy of tenofovir combined with Anluo Huaxian Pills in compensated cirrhosis patients with chronic hepatitis B

目的探讨替诺福韦联合安络化纤丸治疗乙肝肝硬化代偿期患者的抗肝纤维疗效。方法回顾性分析感染内科门诊乙肝肝硬化代偿期患者的病历资料,单用替诺福韦治疗的作为对照组,在对照组治疗的基础上联合使用安络化纤丸治疗的作为观察组。收集2组患者的基线数据以及一般资料,收集治疗96周后2组患者乙型肝炎病毒定量(HBV-DNA)、丙氨酸氨基转移酶(ALT)、总胆红素(TB)、肝纤维化扫描测值(LSM)、门静脉宽度(PL)、脾静脉宽度(SPL)和天冬氨酸氨基转换酶(AST)/血小板(PLT)指数(APRI)的数据,通过组间比较与组内比较对替诺福韦联合安络化纤丸治疗乙肝肝硬化代偿期患者抗病毒及抗肝纤维的疗效做出评价。结果观察组HBV-DNA转阴率为95.73%,对照组HBV-DNA转阴率为94.44%,2组比较差异无统计学意义;治疗后观察组TB、APRI、LSM、PL和SPL明显低于对照组(P<0.05)。观察组最常见的不良反应依次为腹胀、腹泻、口苦、低磷血症、肌酐升高,对照组最常见的不良反应依次为口苦、肌酐升高、乏力、低磷血症、头晕,不良反应的发生率均低于4%。结论替诺福韦联合安络化纤丸治疗乙肝肝硬化代偿期的抗病毒疗效与单用替诺福韦相当,抗肝纤维化疗效显著优于单用替诺福韦,且安全性高。

Objective To analyze the treatment efficacy of tenofovir combined with Anluo Huaxian Pills in compensated cirrhosis patients with chronic hepatitis B.Methods A retrospective analysis of the medical records of the compensated cirrhosis patients was performed in a infectious disease outpatient department.Patients who used tenofovir were classified as control group,and patients who used tenofovir combined with Anluo Huaxian Pills were classified as observation group.The useful medical information and baseline data were collected.After 96 weeks of the treatment,the hepa titis B virus quantitation(HBV-DNA),alanine transaminase(ALT),total bilirubin(TB),liver fibrosis scanning measurement value(LSM),portal vein width(PL),splenic vein width(SPL)and aspartate aminotrans ferase(AST)and platelet(PLT)index(APRI)of the 2 groups were compared to evaluate the efficacy.Results The HBV-DNA negative conversion rate was 95.73%in the observation group and 94.44%in the control group,with no statistical difference.After treatment,the TB,APRI,LSM,PL and SPL in observation group were significantly lower than in control group(P<0.05).The most common adverse reactions in the observation group were abdominal distension,diarrhea,oral bitterness,hypophosphatemia,and increased creatinine,while the most common adverse reactions in the control group were oral bitterness,increased creatinine,fatigue,hypophos phatemia,and dizziness.The incidence of adverse reactions in both groups were lower than 4%.Conclusion The antiviral effect of tenofovir combined with Anluo Huaxian Pills is comparative with tenofovir alone,and the antiliver fibrosis effect is signi ficantly better than that of tenofovir applica tion alone with high safety in compensated cirrhosis patients with chronic hepatitis B.