探讨柔肝化纤颗粒联合核苷类抗病毒药物对乙型肝炎后肝硬化失代偿期患者肝功能及门静脉系统血流动力学的影响

To investigate the effect of Rougan Huaxian Granule combined with nucleoside antiviral drugs on liver function and portal venous system hemodynamics in patients with hepatitis B decompensated cirrhosis

目的探究与分析柔肝化纤颗粒联合核苷类抗病毒药物对乙型肝炎后肝硬化失代偿期患者肝功能及门静脉系统血流动力学的影响。方法选取自2018年2月~2022年2月门诊乙型肝炎后肝硬化失代偿期患者88例,采取随机数字表法分为对照组与观察组,每组各44例,对照组给予常规护肝与核苷类抗病毒治疗,观察组在其基础上增加柔肝化纤颗粒治疗,对比两组患者临床疗效、抗病毒相关指标变化,治疗前后肝功能及肝纤维化指标、门静脉系统血流动力学指标,同时观察对肝脾影像学指标变化情况。结果观察组与对照组相比临床有效率较高,HBV DNA转阴率、HBsAg转阴率、HBeAg转阴率、HBeAg/HBeAb血清转换率均较高,差异有统计学意义(P<0.05)。治疗后,观察组与对照组相比,ALT、AST、TBil、LN、HA、PCⅢ、CIV水平均较低,ALB水平较高(P<0.05);Dpv和Dsv较低,门静脉内径和脾静脉内径缩短,差异有统计学意义(P<0.05)。结论柔肝化纤颗粒联合核苷类抗病毒药物治疗乙型肝炎后肝硬化失代偿期患者的临床疗效显著,抗病毒效果突出,同时可促进改善患者的肝功能指标以及门静脉系统血流动力学指标,影像学指标也得以恢复。

Objective To explore and analyze the effect of Rougan Huaxian Granules combined with nucleoside antiviral drugs on liver function and portal venous system hemodynamics in patients with hepatitis B decompensated cirrhosis.Methods A total of 88 patients with hepatitis B decompensated cirrhosis who were admitted to our hospital from February 2018 to February 2022 were selected and randomly divided into the control group and the observation group by random number table method,with 44 cases in each group and the control group.The group was given routine liver protection and nucleoside antiviral therapy,and the observation group was additionally treated with Rougan Huaxian Granules.Systemic hemodynamic indexes and changes in liver and spleen imaging indexes were also observed.Results Compared with the control group,the observation group had a higher clinical effective rate,and the HBV DNA negative rate,HBsAg negative rate,HBeAg negative rate,and HBeAg/HBeAb seroconversion rate were all higher,and the difference was statistically significant(P<0.05).Compared with the control group after treatment,the observation group had lower ALT,lower AST,higher ALB,lower TBil,lower LN,lower HA,lower PCIII,lower CIV,lower Dpv and lower Dsv,portal vein diameter shortened,splenic vein diameter shortened,and the difference was statistically significant(P<0.05).Conclusion Rougan Huaxian Granules combined with nucleoside antiviral drugs have significant clinical efficacy in the treatment of patients with hepatitis B decompensated cirrhosis,the antiviral effect is outstanding,and can promote the improvement of liver function indexes and portal venous system hemodynamics indicators,and imaging indicators were also recovered.