熊去氧胆酸联合阿德福韦酯和替比夫定治疗失代偿期乙型肝炎肝硬化的疗效观察

发布时间：2018-06-27 06:14

本文选题：牛磺熊去氧胆酸胶囊 + 阿德福韦酯片　；参考：《现代药物与临床》2016年09期

【摘要】：目的探究熊去氧胆酸联合阿德福韦酯和替比夫定治疗失代偿期乙型肝炎肝硬化的临床疗效。方法选择2012年5月—2014年5月西安市第八医院收治的失代偿期乙型肝炎肝硬化患者128例作为研究对象,随机分为对照组和治疗组,每组各64例。对照组口服阿德福韦酯片,10 mg/次,1次/d;同时口服替比夫定片,600 mg/次,1次/d。治疗组在对照组基础上口服牛磺熊去氧胆酸胶囊,10 mg/kg,3次/d。两组患者均治疗50周。观察两组的临床疗效,比较两组抗病毒疗效、肝功能指标和Child-Pugh评分。结果治疗后,对照组和治疗组的总有效率分别为84.3%、85.9%,两组比较差异无统计学意义;但是两组显著改善率分别为54.7%、68.7%,有效率分别为29.7%、17.2%,两组比较差异有统计学意义(P0.05)。治疗后,两组脱氧核糖核酸(HBV-DNA)转阴率、乙型肝炎e抗原(HBe Ag)血清学转换率、丙氨酸转氨酶(ALT)复常率及病毒学突破率比较差异均无统计学意义。治疗后,两组白蛋白(ALB)和凝血酶原活动度(PTA)均显著升高,而血清总胆红素(TBIL)和ALT均显著下降,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组Child-Pugh评分均明显降低,同组治疗前后差异有统计学意义(P0.05);治疗30周、40周和50周后,治疗组Child-Pugh评分降低幅度比对照组同期更大,两组比较差异具有统计学意义(P0.05)。结论熊去氧胆酸联合阿德福韦酯和替比夫定治疗失代偿期乙型肝炎肝硬化具有较好的临床疗效,能改善患者肝功能,降低Child-Pugh评分,具有一定的临床推广应用价值。
[Abstract]:Objective to investigate the clinical efficacy of ursodeoxycholic acid combined with adefovir and tibivudine in the treatment of decompensated hepatitis B cirrhosis. Methods 128 patients with decompensated hepatitis B cirrhosis treated in Xi'an eighth Hospital from May 2012 to May 2014 were randomly divided into control group (n = 64) and treatment group (n = 64). The control group was treated with adefovir tablets for 10 mg/ d and tibivudine for 600 mg/ d. The treatment group took 10 mg / kg Taurodeoxycholic acid capsule on the basis of control group for 3 times / d. Both groups were treated for 50 weeks. The clinical efficacy of the two groups was observed, and the antiviral efficacy, liver function index and Child-Pugh score were compared between the two groups. Results after treatment, the total effective rates of the control group and the treatment group were 84.3 and 85.9, respectively. There was no significant difference between the two groups, but the improvement rates of the two groups were 54.7 and 68.7, respectively, and the effective rates were 29.7and 17.2.The differences between the two groups were statistically significant (P0.05). After treatment, there was no significant difference in the conversion rate of HBV-DNA, the serological conversion rate of hepatitis B e antigen (HBe Ag), the normalization rate of alanine aminotransferase (alt) and the virological breakthrough rate between the two groups. After treatment, albumin (ALB) and prothrombin activity (PTA) increased significantly, while serum total bilirubin (TBIL) and alt decreased significantly. The difference between the same group before and after treatment was statistically significant (P0.05), and the improvement of these observation indexes in the treatment group was significantly better than that in the control group, and the difference between the two groups was statistically significant (P0.05). After treatment, Child-Pugh scores in the two groups were significantly lower than those in the control group (P0.05). After 30 weeks and 50 weeks of treatment, the Child-Pugh score in the treatment group was significantly lower than that in the control group (P0.05). Conclusion ursodeoxycholic acid combined with adefovir dipivoxil and tibivudine are effective in the treatment of patients with decompensated hepatitis B cirrhosis and can improve liver function and reduce Child-Pugh score.
【作者单位】：西安市第八医院药剂科;西安市第八医院肝病科;西安市第八医院化验室;
【分类号】：R512.62;R575.2

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