苦参制剂联合扶正化瘀胶囊对乙型肝炎肝硬化患者肝血流动力学及纤维化指标的影响

发布时间：2018-05-06 05:12

  本文选题：苦参碱 + 苦参素　； 参考：《中国药房》2017年08期

【摘要】：目的:探讨苦参制剂联合扶正化瘀胶囊对乙型肝炎(以下简称"乙肝")肝硬化患者肝血流动力学、纤维化指标的影响及安全性。方法:选取2013年2月-2014年6月我院确诊为乙肝肝硬化患者102例,按随机数字表法分为联合组和对照组,各51例。对照组患者给予阿德福韦酯胶囊10 mg,po,qd;联合组患者在对照组基础上加用扶正化瘀胶囊1.5 g,po,tid+苦参制剂(初始3个月给予苦参碱葡萄糖注射液250 m L,ivgtt,qd,3个月给予苦参素胶囊200 mg,po,tid)。两组患者均持续治疗12个月。观察两组患者治疗前后乙肝病毒脱氧核糖核酸(HBV-DNA)、肝功能指标[天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、总胆红素(TBIL)]、门静脉血流动力学指标[门静脉主干内径(D)、平均血流速度(V)]、肝纤维化指标[层粘连蛋白(LN)、透明质酸(HA)、Ⅳ型胶原(Ⅳ-C)]水平,并记录其HBV-DNA阴转率及不良反应发生率。结果:对照组脱落3例,共48例有效病例入组;联合组脱落5例,共46例有效病例入组。治疗前,两组患者HBV-DNA、肝功能指标(AST、ALT、TBIL)、肝纤维化指标(LN、HA、Ⅳ-C)及门静脉血流动力学指标(D、V)水平比较,差异均无统计学意义(P0.05);治疗后,两组患者上述指标水平均显著降低,且联合组显著低于对照组,差异均有统计学意义(P0.05)。联合组患者HBV-DNA阴转率为93.5%,显著高于对照组的79.2%,差异有统计学意义(P0.05)。两组患者不良反应发生率比较,差异无统计学意义(P0.05)。结论:苦参制剂联合扶正化瘀胶囊能促进乙肝肝硬化患者肝功能恢复、调节肝区血流动力学状态、缓解纤维化,且安全性较好。
[Abstract]:Objective: to investigate the effect and safety of Sophora flavescens preparation combined with Fuzheng Huayu capsule on hepatic hemodynamics and fibrosis in patients with liver cirrhosis. Methods: 102 patients with hepatitis B cirrhosis diagnosed in our hospital from February 2013 to June 2014 were randomly divided into two groups: the combined group and the control group (51 cases each). The patients in the control group were treated with adefovir ester capsule 10 mg / potiqdand the patients in the combined group were treated with 1. 5 g of Fuzheng Huayu capsule and 1. 5 g potid matrine preparation on the basis of the control group (3 months after administration of matrine glucose injection 250 mL) iv gttt QD, and 3 months with matrine capsule 200 mg potid. Both groups were treated continuously for 12 months. Before and after treatment, HBV-DNA, liver function index [aspartate transaminase (alt), alanine aminotransferase (alt), total bilirubin (TBIL)], portal vein hemodynamics (portal vein diameter, mean blood flow) were observed in both groups. The level of hepatic fibrosis index [laminin, hyaluronate, collagen type 鈪，

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