目的 探究复方鳖甲软肝片联合富马酸替诺福韦二吡呋酯片治疗慢性乙型肝炎肝硬化的临床疗效。方法 选择2018年2月-2021年3月在河南省直第三人民医院就诊治疗的122例慢性乙型肝炎肝硬化患者,将所有患者按照随机双盲法分为对照组和治疗组,每组各61例。对照组口服富马酸替诺福韦二吡呋酯片, 1片/次, 1次/d。治疗组在对照组治疗的基础上口服复方鳖甲软肝片, 4片/次, 3次/d。两组患者均治疗6个月。观察两组的临床疗效,比较两组患者治疗前后的肝功能指标、肝纤维化指标和炎性因子水平。结果 治疗后,治疗组患者的总有效率(96.72%)高于对照组(86.88%),组间比较差异具有显著性(P<0.05)。治疗后,两组患者丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转氨酶(AST)、总胆红素(TBIL)水平明显降低,同组比较具有差异(P<0.05);并且治疗组ALT、AST、TBIL水平较对照组更低,组间比较差异具有显著性(P<0.05)。治疗后,两组透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、层黏连蛋白(LN)水平较治疗前均降低,同组比较有差异(P<0.05);并且治疗组HA、PCⅢ、LN水平均较对照组更低,组间比较有差异(P<0.05)。治疗后,两组患者白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、丙二醛(MDA)水平均较治疗前明显降低,同组比较有差异(P<0.05),并且治疗组IL-6、hs-CRP、MDA水平较对照组降低明显,组间比较有差异(P<0.05)。结论 复方鳖甲软肝片联合富马酸替诺福韦二吡呋酯片治疗慢性乙型肝炎肝硬化具有较好的临床疗效,可改善肝功能,降低炎性因子水平,值得临床上借鉴。

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

国家自然科学基金资助项目(81303096)