复方鳖甲软肝片对乙肝肝硬化患者PD/PVa比值、Fibroscan和eGFR的影响  

Effect of Fufang Biejia Ruangan Tablets on PD/PVa Fibroscan and e GFR in Treatment of Patients with Chronic Hepatitis B Cirrhosis

作　　者：程贤文[1] 稂慧芳 黄灵跃 曾如雪 傅燕燕[1] 倪伟[1] 施维群[1] 

机构地区：[1]浙江中医药大学附属第二医院,浙江杭州310005 [2]南华大学,湖南衡阳421000

出　　处：《云南中医学院学报》2016年第5期74-77,89,共5页Journal of Yunnan University of Traditional Chinese Medicine

基　　金：中国肝炎防治基金会王宝恩肝纤维化研究基金(Xjs001);浙江省中医药管理局项目(2016ZB005)

摘　　要：目的观察复方鳖甲软肝片对拉米夫定(贺普丁)联合阿德福韦酯(贺维力)治疗的慢乙肝肝硬化门脉高压患者的临床疗效和安全性。方法选94例乙肝肝硬化门脉高压患者,随机分为观察组48例和对照组46例,观察组给予贺维力联合贺普丁(简称双贺)及复方鳖甲软肝片治疗,对照组予"双贺"联合抗病毒治疗。疗程各12个月,观察门静脉主干直径(PD)与门脉血流平均速度(PVa)的比值、肝脏Febroscan(LSM)、FIB4指数、肾小球率过滤(e GFR)、尿蛋白四项、HBVDNA载量、child-pugh量化评分(CTP评分)。结果治疗12月后比较,观察组CTP评分及HBADNA载量与对照组比较,差异均无统计学意义(P>0.05);观察组PD/PVa比值与对照组比较,差异有统计学意义(P<0.05);LSM及FIB4改善,观察组较对照组差异有统计学意义(P<0.05);观察组e GFR较对照组改善明显(P<0.05),尿蛋白4项观察组较对照组差异有统计学意义(P<0.05)。结论复方鳖甲软肝片对"双贺"治疗的乙肝肝硬化患者通过抗肝纤维化、加快门脉平均血流速度、降低门脉直径等作用改善门静脉血流动力学,同时对患者肾功能有改善作用,临床运用安全性良好,但对肝硬化门脉高压患者的child-pugh评分及病毒载量无显著影响。Objective To observe the clinical effect and Security of Fufang Biejia Ruangan pills Lamivudine and Adefovir on portal hypertension in patients with liver cirrhosis. Methods The 94 patients with liver cirrhosis portal hypertension, were randomly divided into two groups： the observational group with 35 cases oraling Fufang Bijia Ruangan tablets, Lamivudine and Adefovir, and the control group 33 oraling only antiviral drugs. And the treatment lasted 12 monthes. The message of HBVDNA, PD, PVa, ALT, AST, PLT, LSM, CTP, Serum creatinine and Four urinary protein signs were recorded at baseline, 6th month, 12th month. Results Observational group was statistically significant than the control group in PD/PVa, FIB4, LSM, eGFR, IGU and odM1 （P〈0.05）. But, in other hands, for example HBVDNA, CTP, TRU and MA, two groups was no significant difference （P〉0.05）. Conclusion Fufang Bijia Ruangan tablets, being security, can improve Portal hemody namics by lightening Liver Fibrosis, reducing the diameter of portal vein, increasing Portal vein mean velocity, and can protecting the renal function.

关 键 词：复方鳖甲软肝片 门脉高压 乙肝肝硬化 抗病毒 肝纤维化 

分 类 号：R256.4[医药卫生—中医内科学]