复方鳖甲软肝片联合恩替卡韦治疗代偿期乙型肝炎肝硬化的疗效及成本效益分析

发布时间：2018-06-25 11:20

本文选题：慢性乙型肝炎 + 抗病毒治疗　；参考：《解放军药学学报》2016年01期

【摘要】：目的应用肝纤维化无创扫描仪评价复方鳖甲软肝片联合恩替卡韦治疗代偿期乙型肝炎肝硬化患者的疗效及成本效益。方法 2011年6月至2012年6月,前瞻性纳入患者183例,随机分为联合治疗组(98例,复方鳖甲软肝片2 g,每日3次;恩替卡韦片0.5 mg,每日1次,口服)、单药治疗组(85例,恩替卡韦片0.5 mg,每日1次,口服),疗程为24个月,观察2组患者肝硬度指标变化及肝功能复常率、乙型肝炎病毒阴转率、HBe Ag阴转率、肝癌及肝硬化失代偿发生率,并对肝硬度好转所需成本进行分析。结果治疗24个月后联合治疗组较单药治疗组肝硬度下降明显〔(12.6±3.8)k Pa vs(17.6±2.2)k Pa,P0.05〕;出现肝硬度下降比例更高(81/98 vs 43/85),(P0.05);肝功能复常率、HBV-DNA阴转率、HBe Ag阴转率、肝癌及失代偿发生率2组均无显著差异。治疗6个月及24个月时,发生肝硬度下降几率每增加1%则增加治疗成本分别为2382元和505元。结论长期应用复方鳖甲软肝片联合恩替卡韦治疗代偿期乙型肝炎肝硬化较单独应用恩替卡韦可以减轻肝硬化程度,肝纤维化改善患者比例更多。从经济学角度考虑,抗病毒治疗6个月后再联合复方鳖甲软肝片治疗其成本效益更佳。
[Abstract]:Objective to evaluate the efficacy and cost-effectiveness of compound Biejia Ruanggan tablets combined with entecavir in the treatment of compensatory hepatitis B cirrhosis patients with hepatic fibrosis noninvasive scanner. Methods from June 2011 to June 2012, 183 prospective patients were randomly divided into two groups: the combined treatment group (98 cases), the compound Biejia Ruangan tablet (2 g, 3 times a day), the entecavir tablet (0.5 mg, once a day, orally), the single drug treatment group (85 cases), The treatment course was 24 months. The changes of liver hardness index, liver function recovery rate, hepatitis B virus negative conversion rate and HBe Ag negative conversion rate, liver cancer and liver cirrhosis decompensation rate were observed in two groups. The cost of improving liver hardness was analyzed. Results after 24 months of treatment, the liver hardness decreased significantly (12.6 卤3.8) KPA vs (17.6 卤2.2) KPA in the combined treatment group (P 0.05), the decrease rate of liver hardness was higher (81 / 98 vs 43 / 85), (P 0.05), the liver function normalization rate was significantly lower than that in the single drug group (12.6 卤3.8) KPA vs (17.6 卤2.2) KPA, and the HBV-DNA negative conversion rate and HBe Ag negative conversion rate were significantly higher in the combined treatment group (81 / 98 vs 43 / 85), (P0.05). There was no significant difference in the incidence of liver cancer and decompensation between the two groups. After 6 months and 24 months of treatment, the cost of treatment was 2382 yuan and 2382 yuan respectively for every 1% increase in the probability of liver hardness reduction. Conclusion the long-term application of compound Biejia Ruanggan tablets combined with entecavir in the treatment of compensatory hepatitis B cirrhosis can reduce the degree of cirrhosis, and the proportion of patients with liver fibrosis is more. From the economic point of view, it is more cost-effective to combine with compound Biejia Ruangan tablet after 6 months of antiviral therapy.
【作者单位】：解放军302医院肝纤维化诊疗中心;
【基金】：中国肝炎防治基金会王宝恩肝纤维化研究基金;No.xjs20110408
【分类号】：R512.62;R575.2

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