拉米夫定、阿德福韦酯联合扶正化瘀胶囊治疗乙肝后肝硬化失代偿期的2年疗效观察

目的观察拉米夫定、阿德福韦酯联合扶正化瘀胶囊对于乙肝后肝硬化失代偿期治疗作用。方法将51例乙肝后肝硬化失代偿期患者随机分为两组。对照组(n=21)用常规西药治疗方法,如维生素类和护肝降酶治疗,必要时用人血白蛋白等;治疗组(n=30)给予拉米夫定、阿德福韦酯联合扶正化瘀胶囊,疗程均为2年。观察治疗前后HBV-DNA载量,Child-Pugh评分,透明质酸(HA)、Ⅲ型前胶原肽(PcⅢ)、Ⅳ型胶原(Ⅳ-C)和层黏蛋白(LN)等血清肝纤维化指标,彩色多普勒检查肝脾形态、门静脉内径(Dpv)、脾静脉内径(Dsv)和脾厚度(st)。结果基线时两组以上观察指标均无统计学差异(P>0.05)。治疗结束时,对照组3例死亡(肝癌1例、上消化道出血2例),自身前后对比疗效改善不明显((P>0.05)。治疗组死亡1例(交通意外),自身前后对比观察指标改善优于对照组(P<0.05)。结论拉米夫定、阿德福韦酯联合扶正化瘀胶囊有明显改善乙肝后肝硬化失代偿期Child-Pugh评分作用和肝脾形态,降低HBV DNA水平。

Efficacy of lamivudine and adefovir diplvoxil combination therapy with Fuzheng Huayu Capsule for patients with hepatitis B virus-related decompensated cirrhosis

Objective To observe the efficacy of lamivudin(LAM) e and adefovir diplvoxil(ADV) combination therapy with Fuzheng Huayu Capsule for patients with hepatitis B virus-related decompensated drrhosis for 2 years.Methods A total of 51 patients with HBV-related cirrhosis were erolled in this study.They were randomly divided into 2 groups: the treatment group(n=30) received LAM and ADV combination therapy with Fuzheng Huayu Capsule for 2 years;the control group(n=21) received general liver-protection.The change of serum liver fibrosis index,portal vein inner diameter,spleen thickness,HBV DNA and Child-Pugh score were observed.Results After 2 years,the HBV DNA level decreased more in the treatment groups(82.8%,on the said index 24/29) than that in control group(11.1%,2/18).No renal dysfunction was observed in both groups.Conclusion LAM and ADV combined with Fuzheng Huayu Capsule is bette choice for patients with HBV-related dccompcnsated cirrhosis.