替比夫定联合复方鳖甲软肝片治疗慢性乙型肝炎肝纤维化的临床观察(1)
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【摘要】目的 观察替比夫定联合复方鳖甲软肝片治疗慢性乙型肝炎肝纤维化的临床疗效。方法 选取96例乙肝肝纤维化患者，随机分为两组，治疗组给予替比夫定和复方鳖甲软肝片韦治疗，对照组只给予替比夫定治疗，疗程均为6个月。观察治疗后两组HBV-DNA及肝纤维化指标(HA、LN、PCⅢ、CⅣ)及Fibroscan值(FS)变化情况。结果 治疗后两组患者血清HBV-DNA、肝纤维化指标较治疗前均明显下降，治疗组肝纤维化指标明显低于对照组(P<0.01)。结论 替比夫定联合复方鳖甲软肝片即能有效抑制乙肝病毒复制，同时可以明显改善慢性乙型肝炎肝纤维化指标。
【关键词】替比夫定 复方鳖甲软肝片 慢性乙型肝炎 肝纤维化
中图分类号：R512.62文献标识码：A文章编号：1005-0515(2011)4-001-02
Observation of therapeutic effects of Telbivudine combined with Compound Biejia Ruangan Tablets in the treatment of chronic hepatitis B with hepat-ic fibrosis
【Abstract】Objective To study the therapeutic effects of Telbivudine combined with Compound Biejia Ruangan Tablets in treating Chronic hepatitis B with hepatic fibrosis. Methods 96 cases of chronic hepatitis B with hepatic fibrosis were ran-domly divided into two groups:treatment group and control group.The treatment group was treated with Telbivudine and Compound Biejia Ruangan Tablets while the control group was treated only with Telbivudine for 6 months.Levels of HBV-DNA,HA,LN,PCⅢ,CIV and Fibroscan values were ob-served before and after treatment.Results After therapy,the level of HBV-DNA,HA,LN,PCⅢ, CIV and Fibroscan values in two groupsdeclined apparently.The levels of HA,LN,PCIII ,CIV and Fibroscan values in the treated group declined apparently,compared with the control group, there was obviously difference(P<0.01).Conclusion Telbivudine combined with Compound Biejia Ruangan Tablets have obvious activity against HBV and meliorated Chronic hepatitis B with hepatic fibrosis.
【Key words】Telbivudine Compound Biejia Ruangan Tablets Chronic hepatitis B Hepatic fibrosis
肝纤维化是各种慢性肝病损伤修复过程的共同结果,由于肝内纤维生成和降解失衡,导致过多的胶原在肝内沉积,常伴有炎症,最终可发展成肝硬化。研究表明[1],如果肝纤维化、至早期肝硬化得到及时治疗可发生逆转。目前通过抑制病毒及控制肝纤维化以延缓或阻止病情向肝硬化发展还是目前慢性乙肝治疗的主要环节。我院近几年采用替比夫定联合复方鳖甲软肝片治疗慢性乙型病毒性肝炎肝纤维化患者,取得一定效果,现报道如下：
1资料与方法
1.1一般资料96例患者均为2008年12月至2010年10月住我院患者,诊断符合2000年9月西安第10次全国病毒性肝炎学术会议修订的诊断标准[2]。96例患者中，男71例、女25例，年龄26～55岁，平均(42.2±9.6)岁，随机分为替比夫定联合复方鳖甲软肝片治疗组、替比夫定对照组，每组48例。两组患者年龄、性别比较，差异无统计学意义(P>0.05)，两组治疗前HBV-DNA水平、肝纤维化指标(HA、LN、PCⅢ、CIV)、Fibroscan值(FS)比较，差异无统计学意义(P>0.05)，具有可比性。
1.2入选条件患者治疗前及治疗过程中不用其它抗病毒和抗肝纤维化药物，所有病例均HBV-DNA阳性、ALT升高并排除肝硬化、肝癌及重叠其他病毒性肝炎或酒精性、自身免疫性及药物性肝病。
1.3治疗方法治疗组患者替比夫定600 mg/次,1次/d，复方鳖甲软肝片2.0g/次, 3次/d;对照组患者采用替比夫定片600 mg/次, 1次/d。两组疗程均为6个月 ......
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