替诺福韦酯片联合扶正化瘀胶囊治疗乙型肝炎肝硬化疗效观察

Observation on the effect of tenofovir tablet combined with fuzheng huayu capsule in the treatment of hepatitis b cirrhosis

目的 观察替诺福韦酯联合扶正化瘀胶囊对代偿性乙型肝炎肝硬化的抗肝纤维化治疗效果。方法 选择代偿期乙肝肝硬化患者60例,随机分为观察组、对照组,各30例。观察组服用替诺福韦酯和扶正化瘀胶囊,对照组服用替诺福韦酯,连续治疗30个月。分别比较两组患者治疗前后ALB、PTA、APRI均值;比较两组治疗前后门静脉内径、脾脏厚度、门静脉最大流量均值;比较两组患者治疗前后肝脏硬度检测结果;比较两组患者治疗后肝功能、HBVDNA、HBeAg的检测结果。结果 两组患者治疗后肝功能均正常,HBVDNA均降至检测线以下,两组患者分别有42%,36.8%HBeAg阴转;两组患者治疗前后血清ALB、PTA、APRI均值比较,差异均有统计学意义(P<0.05);进一步比较两组治疗后ALB、PTA、APRI,差异均有统计学意义(P<0.05);观察组治疗前后门静脉内径、脾脏厚度、门静脉最大流量均值比较,差异均有统计学意义(P<0.05),而对照组治疗前后比较,差异无统计学意义(P>0.05)。观察组与对照组治疗后门静脉内径、脾脏厚度、门脉最大流量均值比较,差异有统计学意义(P<0.05);两组患者治疗后肝脏硬度检测均值比较,差异有统计学意义(P<0.05),观察组优于对照组。结论 两种治疗方法改善肝脏功能、抗病毒治疗均有显著效果。替诺福韦酯联合扶正化瘀胶囊治疗组改善肝脏血液循环及肝纤维化程度,降低门静脉压力治疗效果优于单用替诺福韦酯组。

Objective To observe the anti-fibrosis effect of tenofovir combined with fuzheng huayu capsule in the treatment of compensatory hepatitis B cirrhosis.Methods Sixty patients with compensatory hepatitis b cirrhosis were randomly divided into observation group and control group.The observation group received tenofovir and fuzheng huayu capsule, while the control group received tenofovir for 30 months.The mean values of ALB,PTA and APRI before and after treatment were compared.The inner diameter of portal vein, thickness of spleen and mean of maximum flow of portal vein before and after treatment were compared in the two groups.Liver hardness test results before and after treatment were compared between the two groups.Results The results of liver function, HBVDNA and HBeAg were compared between the two groups.results after treatment, liver function was normal in both groups, HBVDNA decreased below the detection line, and there were 42% and 36.8% negative HBeAg in the two groups, respectively.The mean values of ALB,PTA and APRI in serum of the two groups were compared before and after treatment.After further comparison, ALB,PTA and APRI of the two groups were all P<0.05.Comparison of portal vein diameter, spleen thickness and portal vein maximum flow mean before and after treatment in the observation group showed P<0.05,while comparison of portal vein diameter before and after treatment in the control group showed P>0.05.Comparison of portal vein diameter, spleen thickness and maximum portal vein flow between the observation group and the control group after treatment showed P<0.05.After treatment, the mean value of liver hardness test in the two groups was P<0.05,and the observation group was better than the control group.Conclusion The two methods can improve liver function and antiviral therapy.Tenofovir combined with fuzheng huayu capsule improved liver circulation and liver fibrosis and reduced portal vein pressure in the treatment group, which was better than tenofovir alone.