[1]张瑞凤,毕东敏,游忠岚,等.扶正化瘀胶囊联合替诺福韦治疗乙肝肝纤维化的疗效观察[J].第三军医大学学报,2016,38(21):2363-2367.
 Zhang Ruifeng,Bi Dongmin,You Zhonglan,et al.Efficiency of Fuzheng Huayu Capsule combined with tenofovir in treatment of hepatitis B liver fibrosis[J].J Third Mil Med Univ,2016,38(21):2363-2367.
点击复制

扶正化瘀胶囊联合替诺福韦治疗乙肝肝纤维化的疗效观察(/HTML )
分享到:

《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
38卷
期数:
2016年第21期
页码:
2363-2367
栏目:
临床医学
出版日期:
2016-11-15

文章信息/Info

Title:
Efficiency of Fuzheng Huayu Capsule combined with tenofovir in treatment of hepatitis B liver fibrosis
作者:
张瑞凤毕东敏游忠岚田展飞王宇明周智宏张国顺余亮科宋敬华袁强
华北理工大学附属医院感染科;第三军医大学西南医院感染科,感染病研究重庆市重点实验室;解放军161医院感染科
Author(s):
Zhang Ruifeng Bi Dongmin You Zhonglan Tian Zhanfei Wang Yuming Zhou Zhihong Zhang Guoshun Yu Liangke Song Jinghua Yuan Qiang

Department of Infectious Diseases, Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei Province, 063007; Department of Infectious Diseases, Chongqing Key Laboratory for Infectious Disease Research, Southwest Hospital, Third Military Medical University, Chongqing, 400038, Department of Infectious Diseases, No.161 Hospital of PLA, Wuhan, Hubei Province, 430010, China

关键词:
扶正化瘀胶囊替诺福韦慢性乙型肝炎肝纤维化疗效
Keywords:
Fuzheng Huayu Capsule tenofovir chronic hepatitis B hepatic fibrosis curative effect
分类号:
R286; R575.2; R978.7
文献标志码:
A
摘要:

目的      观察扶正化瘀胶囊联合替诺福韦治疗乙肝肝纤维化的疗效。方法     对116例慢乙肝肝纤维化患者的临床资料进行回顾性分析,根据用药的不同,分为单药组和联合组。单药组(56例)服用替诺福韦 300 mg/次,1次/d,疗程72周;联合组(60例)服用替诺福韦(剂量及其疗程同单药组)加扶正化瘀胶囊1.5 g/次,3次/d,疗程72周;观察比较其治疗前后肝功能指标、乙肝病毒(HBV)DNA定量、HBV血清学标志物、肝纤维化4项、腹部超声及Fibrosean测量指标肝脏硬度值(LSM)肝纤维化无创指标的变化。结果两组患者肝功能均恢复正常;HBV DNA<500 拷贝/mL的比例分别为82.14%(46/56)、86.67%(52/ 60),差异无统计学意义(P>0.05);HBeAg血清学转换率为21.43%(12/56)、23.33%(14/60),差异无统计学意义(P>0.05);联合组肝纤维化4项指标较单药组显著下降(P<0.05);治疗后腹部超声检测指标门静脉直径、门静脉血流速度、脾脏厚度和门脉血流量组间比较差异均有统计学意义(P<0.05);LSM值治疗后均降低,且联合组与单药组比较,差异有统计学意义(P<0.05)。结论     采用扶正化瘀胶囊与替诺福韦联合治疗乙肝肝纤维化较单纯西药疗效显著,是值得临床推广的新方法。

Abstract:

Objective      To determine the curative effect of Fuzheng Huayu Capsule (a prescription of traditional Chinese medicine based on anti-viral herbs) combined with tenofovir in treatment of hepatitis B liver fibrosis.  Methods     Clinical data of 116 patients with chronic hepatitis B liver fibrosis who admitted in the Southwest Hospital and the Affiliated Hospital of North China University of Science and Technology from July 2014 to January 2016 were collected and retrospectively analyzed. According to their treatment, the patients were divided into the single drug group (n=56, 300 mg/d tenofovir, once per day, for 72 weeks) and the combined group (n=60, tenofovir at the same dose and course as the single drug group combined with 1.5 g Fuzheng Huayu Capsule, 3 times per day, for 72 weeks). The liver function, HBV DNA copy number, HBV serological indicators,  liver fibrosis indicators were measured, and abdomen ultrasonography and Fibroscan testing was carried out before and after the treatment. The above indicators and results were compared between the 2 groups.  Results     The liver function were returned to normal in the both groups of patients. The proportion of the patients with HBV DNA <500 copy/mL was 82.14% (46/56) in the single drug group and 86.67% (52/60) in the combined group, without significant difference (P>0.05). The rate of HBeAg sero-conversion was 21.43% (12/56) in the former and 23.33% (14/60) in the latter group, and no statistical significance was found (P>0.05). The 4 indicators of liver fibrosis were significantly lower in the combined group than the single drug group (P<0.05). After treatment, abdominal ultrasound examination showed that obvious differences were seen in portal vein diameter and blood flow velocity, spleen length and portal blood flow between the 2 groups (P<0.05). The liver stiffness measure (LSM) values were decreased after treatment, and statistical significance was observed between the 2 groups (P<0.05).  Conclusion     Combination of Fuzheng Huayu Capsule and tenofovir is more effective  in the treatment of hepatitis B liver fibrosis, and it is worthy of clinical promotion.

参考文献/References:

[1]中国中西医结合学会肝病专业委员会.肝纤维化中西结合诊疗指南[J].中国肝脏病杂志: 电子版, 2010, 2(4): 54-59.
[2]田玉玲, 朱晓云, 殷卫卫, 等.扶正化瘀胶囊序贯联合核苷(酸)类似物对慢性乙型肝炎纤维化指标的影响[J].中华肝脏病杂志, 2013, 21(7): 514-518.DOI: 10.3760/cma.j.issn.1007-3418.2013.07.010
[3]郑仁源, 黄涛, 蒲玲玲, 等.扶正化瘀胶囊联合恩替卡韦抗纤维化治疗的系统评价[J].内蒙古中医药, 2014, (16): 55-57.
[4]李国焕, 舒盼, 张均倡, 等.恩替卡韦联合扶正化瘀胶囊治疗乙型肝炎肝硬化疗效观察[J].实用肝脏病杂志, 2015, 18(6): 616-619. DOI: 10.3969/j.issn.1005-0264.2015.04.09
[5]徐长春, 韦明, 程红波, 等.扶正化瘀胶囊联合恩替卡韦分散片治疗乙型肝炎肝硬化代偿期疗效观察[J]. 中药药理与临床, 2015, 31(1): 293-294.  DOI: 10.3969/j.issn.1001-5256.2015.04.030
[6]幕永平, 刘成海, 张华, 等.肝硬化虚损生积论-刘平教授学术思想浅析[J].上海中医药大学学报, 2013, 27(2): 1-4.
[7]徐列明.扶正化瘀片美国Ⅱ期临床试验结束后的思考[J].中华中医药杂志, 2015, 30(4): 1168-1170.
[8]雷娜, 郑仕中, 陆茵.活血化瘀类中药防治肝纤维化的机制及研究进展[J].中国中医药杂志, 2010, 25(2): 265-268.
[9]Buti M, Tsai N, Petersen J, Flisiak R, et al. Seven-year efficacy and safety of treatment with tenofovir disoproxil fumarate for chronic hepatitis B virus infection[J]. Dig Dis Sci, 2015,60(5):1457-1464. DOI:10.1007/s10620-014-3486-7
[10]Berg T, Zoulim F, Moeiier B, et al.Longterm efficacy and safety of emtricitabine plus tenofovir DF vs.tenofovir  DF monotherapy in adefovir- experiencedchronic hepatitis B patients[J].J hepatology 2014,  60(4): 715-22.DOI: 10.1016/j.jhep.2013.11.024.Epub 2013 Dec 1.PMID: 24295873
[11]中华医学会肝病学分会, 中华医学会感染病学分会.慢性乙型肝炎防治指南(2015年版)[J].中华实验和临床感染病杂志(电子版), 2015, 9(5): 570-589.DOI: 10.3969/j.issn.1674-7308.2015.03.001
[12]Marcellin P,  Gane E,  Buti M,  et al. Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B:  a 5-year open-label follow-up study[J].Lancet, 2013, 381(9865): 468-475.DOI: 10.1016/SO140-6736(12)61425-1.Epub 2012 Dec 10.PMID: 23234725.
[13]姚光弼, 任红.慢性乙型肝炎患者持续应用恩替卡韦治疗3年的疗效[J].中华肝脏病杂志, 2009, 174(12): 881-886.
[14]刘小芳, 马建.慢性乙型肝炎中医辩证分型与肝功能指标关系思考[J].现代中西医结合杂志, 2012, 21(9): 1016-1018.
[15]王清兰, 陶艳艳, 沈丽.扶正化瘀方影响转化生长影子β1/Smad信号通路的抗肝纤维化作用机制[J].中西医结合学报, 2012, 10(5): 561-569.
[16]张悦, 吕洋, 李旭, 等.替诺福韦治疗慢性乙型肝炎的最新进展[J].临床肝胆病杂志, 2015, 31(4): 599-602.DOI: 10.3969/j.issn.1001-5256.2015.04.030
[17]张瑞凤.姚云洁.游忠岚, 等.复方鳖甲软肝片联合恩替卡韦治疗慢性乙肝纤维化的观察[J].第三军医大学学报, 2014, 36(18): 1961-1963.
[18]朱冬梅, 叶春艳, 钱梅云, 等.替诺福韦挽救治疗耐药复发的慢性乙型肝炎患者48周疗效初探[J].实用肝脏病杂志, 2016, 19(1): 37-40.DOI:  10.3969/j.issn.16725069.2016.01.010

更新日期/Last Update: 2016-11-10