摘要
目的探讨替诺福韦联合安络化纤丸治疗乙型肝炎肝硬化患者的临床疗效。方法2019年3月~2023年3月徐州市中心医院诊治的乙型肝炎肝硬化患者145例,被随机分为对照组73例和观察组72例,分别给予口服替诺福韦或口服替诺福韦联合安络化纤丸治疗12个月。采用ELISA法检测血清肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)和IL-8水平,采用ELISA法检测血清层粘连蛋白(LN)、Ⅳ型胶原(IV-C)、Ⅲ型前胶原(PCⅢ)和透明质酸(HA)水平。采用中医证候积分评估中医症状改善情况。结果在治疗12个月末,观察组血清TBIL和ALT水平分别为(23.2±5.3)μmol/L和(31.1±2.4)u/L,均显著低于对照组【分别为(36.6±5.1)μmol/L和(41.1±6.4)u/L,P<0.05】,而血清ALB水平为(39.1±7.0)g/L,显著高于对照组【(35.6±5.9)g/L,P<0.05】;观察组血清IV-C、PCⅢ和HA水平分别为(62.5±11.7)ng/mL、(59.3±11.8)ng/mL和(67.0±17.7)ng/mL,均显著低于对照组【分别为(74.7±12.5)ng/mL、(77.5±11.5)ng/mL和(80.6±17.0)ng/mL,P<0.05】;观察组血清TNF-α、IL-6和IL-8水平分别为(6.5±2.2)ng/L、(4.1±1.0)ng/L和(3.1±0.6)ng/L,均显著低于对照组【分别为(10.0±2.4)ng/L、(6.2±1.2)ng/L和(4.4±0.8)ng/L,P<0.05】;观察组中医证候脘痞腹胀、身目发黄、肋下刺痛和口干而苦积分分别为(0.8±0.1)分、(1.0±0.4)分、(0.9±0.4)分和(0.8±0.1)分,均显著低于对照组【分别为(1.7±0.2)分、(2.0±0.2)分、(1.7±0.5)分和(1.4±0.3)分,P<0.05】。结论应用替诺福韦联合安络化纤丸治疗乙型肝炎肝硬化患者可以更有效地改善肝功能和肝纤维化指标,改善中医证候症状,值得长期应用观察。
Objective This study aimed to investigate clinical efficacy of tenofovir and Anluo Huaxian capsule,a herbal medicine compound,combination in the treatment of patients with hepatitis B-induced liver cirrhosis(LC).Methods A prospective study was carried out at Xuzhou Central Hospital,enrolled 145 patients with hepatitis B-induced LC between March 2019 and March 2023,and all were randomly assigned to receive tenofovir disoproxil fumarate(TDF)in 73 cases(control)or TDF with combination of the herbal medicine in another 72 cases(observation)for 12 months.Serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and IL-8 levels were detected by ELISA,and serum laminin(LN),collagen type Ⅳ(Ⅳ-C),precollagen-Ⅲ(PC-Ⅲ)and hyaluronic acid(HA)levels were assayed by ELISA.Traditional Chinese Medicine(TCM)symptom scores were evaluated routinely.Results By end of 12 month treatment,serum bilirubin and alanine aminotransferase levels in the combination group were(23.2±5.3)μmol/L and(31.1±2.4)u/L,both significantly lower than[(36.6±5.1)μmol/L and(41.1±6.4)u/L,respectively,P<0.05],while serum albumin level was(39.1±7.0)g/L,significantly higher than[(35.6±5.9)g/L,P<0.05]in the control;serum IV-C,PCⅢ and HA levels were(62.5±11.7)ng/mL,(59.3±11.8)ng/mL and(67.0±17.7)ng/mL,all significantly lower than[(74.7±12.5)ng/mL,(77.5±11.5)ng/mL and(80.6±17.0)ng/mL,respectively,P<0.05]in the control group;serum TNF-α,IL-6 and IL-8 levels were(6.5±2.2)ng/L,(4.1±1.0)ng/L and(3.1±0.6)ng/L,all significantly lower than[(10.0±2.4)ng/L,(6.2±1.2)ng/L and(4.4±0.8)ng/L,respectively,P<0.05]in the control;TCM symptom scores,such as abdominal distension,jaundice,right hypochondrial pain and dry mouth were(0.8±0.1)points,(1.0±0.4)points,(0.9±0.4)points and(0.8±0.1)points,all much lower than[(1.7±0.2)points,(2.0±0.2)points,(1.7±0.5)points and(1.4±0.3)points,respectively,P<0.05]in the control group.Conclusion The combination therapy of tenofovir and herbal medicine,Anluohuaxian capsule in treatment of patients with hepatitis B-related LC is found to be efficacious,with improvement of liver function tests and reduction of serum liver fibrosis markers,especially ameliorates TCM syndromes,and warrants further clinical long-term investigation.
作者
拾倩
李莉
倪昊天
Shi Qian;Li Li;Ni Haotian(Department of Pharmacy,Central Hospital,Xuzhou 221000,Jiangsu Province,China)
出处
《实用肝脏病杂志》
2025年第2期242-245,共4页
Journal of Practical Hepatology
基金
江苏省基础研究计划自然科学基金青年基金资助项目(编号:BK20230588)。
关键词
肝硬化
乙型肝炎
替诺福韦
安络化纤丸
治疗
Liver cirrhosis
Hepatitis B
Tenofovir
Anluo Huaxian capsule,a herbal medicine
Therapy
