舒肝宁注射液联合富马酸丙酚替诺福韦治疗慢性乙型病毒性肝炎的效果

Effect of Shuganning injection combined with tenofovir alafenamide fumarate on chronic viral hepatitis B

目的探讨舒肝宁注射液联合富马酸丙酚替诺福韦治疗慢性乙型病毒性肝炎的临床效果。方法抽取2020年10月至2022年3月驻马店市中心医院收治的慢性乙型病毒性肝炎患者68例,按照随机数字表法分为西医组与中成药组,每组34例。西医组采用富马酸丙酚替诺福韦治疗,中成药组采用舒肝宁注射液联合富马酸丙酚替诺福韦治疗。比较两组治疗效果、肝功能指标[丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)]水平、T淋巴细胞亚群(CD8^(+)、CD4^(+))水平、乙型肝炎病毒的脱氧核糖核酸(HBV-DNA)转阴率、乙型肝炎E抗原(HBeAg)转阴率及不良反应发生率。结果中成药组治疗总有效率(94.12%,32/34)高于西医组(76.47%,26/34),差异有统计学意义(χ^(2)=4.22,P=0.040)。治疗后,中成药组ALT、TBIL水平均低于西医组(P均<0.05)。治疗后,中成药组CD8^(+)水平低于西医组,CD4^(+)水平高于西医组(P<0.05)。中成药组HBV-DNA转阴率(88.24%,30/34)、HBeAg转阴率(61.76%,21/34)均高于西医组(67.65%,23/34;35.29%,12/34),P均<0.05。中成药组不良反应发生率与西医组比较差异未见统计学意义(P>0.05)。结论舒肝宁注射液联合富马酸丙酚替诺福韦治疗慢性乙型病毒性肝炎可提高治疗效果、HBV-DNA转阴率及HBeAg转阴率,并能改善肝功能和免疫功能。

Objective To investigate the clinical effect of Shuganning injection combined with tenofovir alafenamide fumarate on chronic viral hepatitis B.Methods A total of 68 patients with chronic viral hepatitis B treated in Zhumadian Central Hospital from October 2020 to March 2022 were selected,and they were divided into western medicine group and Chinese medicine group according to the random number table method,with 34 cases in each group.The western medicine group was treated with tenofovir alafenamide fumarate,and the Chinese medicine group was treated with Shuganning injection combined with tenofovir alafenamide fumarate.The curative effect,levels of liver function indexes including alanine aminotransferase(ALT)and total bilirubin(TBIL),levels of T lymphocyte subsets including cluster of differentiation 8^(+)(CD8^(+))and cluster of differentiation 4^(+)(CD4^(+)),negative conversion rate of hepatitis B virus-deoxyribonucleic acid(HBV-DNA),negative conversion rate of hepatitis B surface antigen(HBeAg),and incidence of adverse reactions were compared between the two groups.Results The total effective rate of the Chinese medicine group(94.12%,32/34)was higher than that of the western medicine group(76.47%,26/34),and the difference was significant(χ^(2)=4.22,P=0.040).After treatment,the levels of ALT and TBIL in the Chinese medicine group were lower than those in the western medicine group(all P<0.05).After treatment,the level of CD8^(+)in the Chinese medicine group was lower than that in the western medicine group,and the level of CD4^(+)was higher than that in the western medicine group(P<0.05).The negative conversion rate of HBV-DNA and HBeAg in the Chinese medicine group(88.24%,30/34;61.76%,21/34)were higher than those in the western medicine group(67.65%,23/34;35.29%,12/34),all P<0.05.There was no significant difference in the incidence of adverse reactions between the Chinese medicine group and the western medicine group(P>0.05).Conclusions Shuganning injection combined with tenofovir alafenamide fumarate in the treatment of chronic viral hepatitis B can improve the curative effect and negative conversion rate of HBV-DNA and HBeAg,moreover,it can improve the liver function and immune function.