目的 探究復(fù)方鱉甲軟肝片聯(lián)合富馬酸替諾福韋二吡呋酯片治療慢性乙型肝炎肝硬化的臨床療效。方法 選擇2018年2月-2021年3月在河南省直第三人民醫(yī)院就診治療的122例慢性乙型肝炎肝硬化患者,將所有患者按照隨機(jī)雙盲法分為對(duì)照組和治療組,每組各61例。對(duì)照組口服富馬酸替諾福韋二吡呋酯片, 1片/次, 1次/d。治療組在對(duì)照組治療的基礎(chǔ)上口服復(fù)方鱉甲軟肝片, 4片/次, 3次/d。兩組患者均治療6個(gè)月。觀察兩組的臨床療效,比較兩組患者治療前后的肝功能指標(biāo)、肝纖維化指標(biāo)和炎性因子水平。結(jié)果 治療后,治療組患者的總有效率(96.72%)高于對(duì)照組(86.88%),組間比較差異具有顯著性(P<0.05)。治療后,兩組患者丙氨酸氨基轉(zhuǎn)移酶(ALT)、天門冬氨酸氨基轉(zhuǎn)氨酶(AST)、總膽紅素(TBIL)水平明顯降低,同組比較具有差異(P<0.05);并且治療組ALT、AST、TBIL水平較對(duì)照組更低,組間比較差異具有顯著性(P<0.05)。治療后,兩組透明質(zhì)酸(HA)、Ⅲ型前膠原(PCⅢ)、層黏連蛋白(LN)水平較治療前均降低,同組比較有差異(P<0.05);并且治療組HA、PCⅢ、LN水平均較對(duì)照組更低,組間比較有差異(P<0.05)。治療后,兩組患者白細(xì)胞介素-6(IL-6)、超敏C反應(yīng)蛋白(hs-CRP)、丙二醛(MDA)水平均較治療前明顯降低,同組比較有差異(P<0.05),并且治療組IL-6、hs-CRP、MDA水平較對(duì)照組降低明顯,組間比較有差異(P<0.05)。結(jié)論 復(fù)方鱉甲軟肝片聯(lián)合富馬酸替諾福韋二吡呋酯片治療慢性乙型肝炎肝硬化具有較好的臨床療效,可改善肝功能,降低炎性因子水平,值得臨床上借鑒。

Objective To explore the clinical study of Compound Biejia Rugan Tablets combined with Tenofovir Disoproxil Fumarate Tablets in treatment of chronic hepatitis B cirrhosis.Methods Patients (122 cases) with chronic hepatitis B cirrhosis in Henan No. 3 Provincial People’s Hospital from February 2018 to March 2021 were divided into control and treatment groups according to random double-blind method, and each group had 61 cases. Patients in the control group were po administered with Tenofovir Disoproxil Fumarate Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Compound Biejia Rugan Tablets on the basis of the control group, 4 tablets/time, three times daily. Patients in two groups were treated for 6 months. After treatment, the clinical efficacies were evaluated, and the liver function indexes, liver fibrosis indexes, and inflammatory factors level in two groups were compared.Results After treatment, the total effective rate of the treatment group (96.72%) was higher than that of the control group (86.88%), and there was significant difference between the groups (P < 0.05). After treatment, the levels of ALT, AST, and TBIL in two groups were significantly decreased (P < 0.05). The levels of ALT, AST, and TBIL in the treatment group were lower than those in the control group (P < 0.05). After treatment, the levels of HA, PC Ⅲ, and LN in two groups were lower than those before treatment (P < 0.05). The levels of HA, PC Ⅲ, and LN in the treatment group were lower than those in the control group (P < 0.05). After treatment, the levels of IL-6, hs-CRP, and MDA in two groups were significantly lower than those before treatment (P < 0.05), and the levels of IL-6, hs-CRP, and MDA in the treatment group were significantly lower than those in the control group (P < 0.05).Conclusion Compound Biejia Rugan Tablets combined with Tenofovir Disoproxil Fumarate Tablets has better clinical efficacy in treatment of chronic hepatitis B cirrhosis, can improve liver function and reduce the levels of inflammatory factors, which is worthy of clinical reference.

R978.7

國(guó)家自然科學(xué)基金資助項(xiàng)目(81303096)