舒肝宁联合富马酸替诺福韦二吡呋酯对慢性乙肝肝硬化患者免疫功能及肝功能的影响

Effects of Shuganning Combined with Tenofovir Disoproxil Fumarate on Immune Function and Liver Function in Patients with Chronic Hepatitis B Cirrhosis

目的 探讨舒肝宁联合富马酸替诺福韦二吡呋酯(TDF)对慢性乙肝肝硬化患者免疫功能及肝功能的影响。方法 选择2019年8月至2021年5月于本院治疗的122例慢性乙肝肝硬化患者,按随机数字表法将其分为两组,各61例。对照组采用TDF治疗,观察组采用TDF与舒肝宁注射液联合治疗。比较两组患者免疫功能、肝功能、FibroScan值(FS)、乙肝病毒学指标、凝血因子及不良反应。结果 治疗后,两组患者CD4+、CD4+/CD8+均高于治疗前,CD8+低于治疗前,且观察组CD4+、CD4+/CD8+均高于对照组,CD8+低于对照组;治疗后,两组总胆红素(TBil)、氨基酸转氨酶(AST)、丙氨酸转氨酶(ALT)及FS均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);观察组HBV-NA转阴率、乙肝e抗原(HBeAg)转阴率高于对照组,差异有统计学意义(P<0.05);治疗后,两组凝血酶原时间(PT)、国际标准化比值(INR)均低于治疗前,凝血酶原活动度(PTA)均高于治疗前,且观察组PT、INR低于对照组,PTA高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 慢性乙肝肝硬化患者采用舒肝宁与TDF联合治疗有利于改善患者免疫功能及肝功能,抑制病情进展,提高抗病毒疗效,纠正患者的凝血功能异常,且不良反应未增加,临床应用安全可靠。

Objective To investigate the effect of Shuganning combined with tenofovir disoproxil fumarate(TDF) on immune function and liver function in patients with chronic hepatitis B cirrhosis.Methods A total of 122 patients with chronic hepatitis B cirrhosis who were treated in our hospital from August 2019 to May 2021 were selected and divided into two groups according to the random number table method, with 61 cases in each group. The control group was treated with TDF, and the observation group was treated with TDF combined with Shuganning injection. The immune function, liver function, FibroScan value(FS), hepatitis B virological indexes, coagulation factors and adverse reactions were compared between the two groups.Results After treatment, CD4+ and CD4+/CD8+ in the two groups were higher than those before treatment, and CD8+ was lower than before treatment, and CD4+, CD4+/CD8+ in the observation group were higher than those in the control group, and CD8+ was lower than that in the control group;the total bilirubin of the two groups after treatment(TBil), amino acid transaminase(AST), alanine transaminase(ALT) and FS were lower than those before treatment, and the observation group was lower than the control group, the difference was statistically significant(P<0.05). The negative rate of (HBeAg) was higher than that of the control group, and the difference was statistically significant(P<0.05).(PTA) were higher than those before treatment, and the PT and INR of the observation group were lower than those of the control group, and the PTA was higher than that of the control group, and the difference was statistically significant(P<0.05).There was no statistical difference in the total incidence of adverse reactions between the two groups. significance(P>0.05).Conclusion Combination therapy of Shuganning and TDF in patients with chronic hepatitis B cirrhosis is beneficial to improve the immune function and liver function of patients, inhibit the progression of the disease, help to turn HBeAg negative, correct the abnormal blood coagulation function of patients, and the adverse reactions do not increase. Clinical application Safe and reliable.