富马酸替诺福韦二吡呋酯片联合安络化纤丸对慢性乙型肝炎患者的影响

Effect of Tenofovir Disoproxil Fumarate Tablets Combined with Anluo Huaxian Pills on Patients with Chronic Hepatitis B

目的:探究富马酸替诺福韦二吡呋酯片联合安络化纤丸在慢性乙型肝炎(CHB)患者治疗中的应用效果。方法:将上饶市第二人民医院肝病科2022年1月—2023年5月收治的CHB患者80例,根据随机数字表法分为联合组和对照组,各40例,均持续治疗6个月。对照组采用富马酸替诺福韦二吡呋酯片治疗,联合组在对照组基础上加用安络化纤丸。比较两组疗效、病毒学指标、肝功能指标、炎症因子、肝纤维化程度指标、血清转化生长因子-β1(TGF-β1)及血浆内皮素-1(ET-1),并统计治疗期间不良反应发生情况。结果:联合组总缓解率高于对照组,差异有统计学意义(P<0.05);治疗后,两组乙肝表面抗原(HBsAg)、乙肝e抗原(HBeAg)、乙肝病毒的脱氧核糖核酸(HBV-DNA)均较治疗前降低,且联合组均低于对照组,差异均有统计学意义(P<0.05);治疗后,两组丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转氨酶(AST)、总胆红素(TBIL)均较治疗前降低,且联合组均低于对照组,差异均有统计学意义(P<0.05);两组治疗后白蛋白(ALB)均较治疗前增加,且联合组高于对照组,差异均有统计学意义(P<0.05);治疗后,两组血清中肿瘤坏死因子-α(TNF-α)、白细胞介素-17(IL-17)均较治疗前降低,且联合组均低于对照组,差异均有统计学意义(P<0.05);治疗后,两组透明质酸(HA)、Ⅲ型前胶原、层粘连蛋白(LN)、TGF-β1、ET-1均较治疗前下降,且联合组均低于对照组,差异均有统计学意义(P<0.05);治疗期间,两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:富马酸替诺福韦二吡呋酯片联合安络化纤丸在CHB患者治疗中效果较好,可提高抗病毒能力,改善患者肝功能,抑制肝纤维化发展,减轻炎症反应,具有一定安全性。

Objective:To explore the application effect of Tenofovir Disoproxil Fumarate Tablets combined with Anluo Huaxian Pills in the treatment of patients with chronic hepatitis B(CHB).Method:From January 2022 to May 2023,80 patients with CHB admitted to the Department of Hepatology of the Second People's Hospital of Shangrao City were divided into the combined group and the control group by random number table method,with 40 patients in each group.The control group was treated with Tenofovir Disoproxil Fumarate Tablets.The combined group was treated with Anluo Huaxian Pills on the basis of control group.Both groups were given 6 months of treatment.Therapeutic effects,virological indicators,liver function indexes,inflammatory factors,liver fibrosis degree indexes,serum transforming growth factor-β1(TGF-β1)and plasma endothelin-1(ET-1)were compared between the two groups,and the incidence of adverse reactions during treatment was statistically analyzed.Result:The total remission rate in the combined group was higher than that in the control group,the difference was statistically significant(P<0.05).After treatment,the levels of hepatitis B surface antigen(HBsAg),hepatitis Be antigen(HBeAg)and hepatitis B virus deoxyribonucleic acid(HBV-DNA)in two groups were lower than those before treatment,and those of the combined group were lower than those of the control group,with statistical significance(P<0.05).After treatment,alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBIL)in two groups were lower than those before treatment,and those of the combined group were lower than those of control group,the differences were statistically significant(P<0.05).After treatment,albumin(ALB)in both groups were higher than those before treatment,and that of the combined group was higher than that of the control group,the Medical Innovation of China Vol.21,No.33 November,2024 differences were statistically significant(P<0.05).After treatment,the serum tumor necrosis factor-α(TNF-α)and interleukin-17(IL-17)in two groups were lower than those before treatment,and those of the combined group were lower than those of control group,the differences were statistically significant(P<0.05).After treatment,hyaluronic acid(HA),typeⅢprocollagen,laminin(LN),TGF-β1 and ET-1 in two groups were lower than those before treatment,and those of the combined group were lower than those of control group,the differences were statistically significant(P<0.05).During treatment,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Tenofovir Disoproxil Fumarate Tablets combined with Anluo Huaxian Pills is effective in the treatment of CHB.It can improve the patients'antiviral ability and liver function,inhibit the development of liver fibrosis,and reduce inflammatory reactions,with safety.