复方益肝灵片联合替诺福韦治疗肺结核合并慢性乙肝疗效观察  

Clinical Observation of Compound Yiganling Tablet Combined with Tenofovir in the Treatment of Pulmonary Tuberculosis Complicated with Chronic Hepatitis B

作　　者：万丽红 汪敬杰 刘恒 WAN Li-hong;WANG Jing-jie;LIU Heng(Department of Infectious Disease,the Second Hospital of Qinhuangdao,Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市第二医院感染科,河北秦皇岛066000

出　　处：《现代中药研究与实践》2021年第2期86-91,共6页Research and Practice on Chinese Medicines

基　　金：秦皇岛市科学技术局科技计划自筹经费项目(201902A077)。

摘　　要：目的观察复方益肝灵片联合替诺福韦对肺结核合并慢性乙肝患者肝肾功能、肝纤维指标及HBV-DNA转阴率的影响。方法选取2017年1月至2019年1月于本院就诊的肺结核合并慢性乙肝患者120例,通过随机数表法随机分为三组,各40例。A组采用常规化疗方案,B组在此基础上加用复方益肝灵片,C组在B组的基础上联用替诺福韦治疗,对各组患者疗效进行分析比较。结果C组肝损伤程度明显轻于A组(P<0.05);治疗后,三组患者肝功能指标(ALT、AST、TBIL)、肝纤维指标(HA、PⅢNP、Ⅳ-C、LN)、CD8^(+)水平、血清细胞因子(TNF-α、IL-2、IL-6)水平,A组>B组>C组,各组间比较均差异有统计学意义(P<0.05);治疗后,三组免疫功能指标CD4^(+)、CD4^(+)/CD8^(+)比值,C组>B组>A组;B、C组病灶吸收率、HBV转阴率、痰菌转阴率均明显高于A组(P<0.05),结核耐药率均明显低于A组(P<0.05)。结论复方益肝灵片联合替诺福韦能够有效减轻患者肝损伤程度,改善肝纤维化症状,提高HBV-DNA转阴率。这可能与提高了患者的免疫功能,减轻机体的炎症反应有关。Objective To observe the effect of compound Yiganling tablet combined with tenofovir dipivoxil on liver and kidney function,liver fiber index and HBV-DNA negative conversion rate in patients with pulmonary tuberculosis complicated with chronic hepatitis B.Methods 120 patients with pulmonary tuberculosis and chronic hepatitis B admitted to our hospital from January 2017 to January 2019 are randomly divided into three groups by random number table method,with 40 patients in each group.Group A is treated with conventional chemotherapy,group B is treated with compound Yiganling tablet,and group C is treated with tenofovir combination on the basis of group B.The efficacy of each group is analyzed and compared.Results There is no significant difference in renal damage among the three groups,and the degree of liver damage in group C is significantly less than that in group A(P<0.05).Liver function:after treatment,three groups of patients with liver function index(ALT,AST,TBIL)and liver fiber index(HA,PⅢNP,Ⅳ-C,LN),CD8^(+)level,serum levels of cytokines(TNF-α,IL-2,IL-6)level group A>group B>group C,which is compared between each group showed significant difference(P<0.05).After treatment,three groups of immune function indicators CD4^(+),CD4^(+)/CD8^(+)ratio group C>group B>group A;The lesion absorption rate,HBV negative conversion rate and sputum negative conversion rate of group B and C are significantly higher than group A(P<0.05),and the drug resistance rate of tuberculosis is significantly lower than group A(P<0.05).Conclusion Compound Yiganling tablet combined with tenofovir can effectively reduce the degree of liver injury,improve the symptoms of liver fibrosis,and increase the negative conversion rate of HBV-DNA.This may be related to improving the immune function of patients and reducing the body's inflammatory response.

关 键 词：复方益肝灵片 替诺福韦 肺结核合并慢性乙肝 免疫功能 炎症反应 

分 类 号：R285.6[医药卫生—中药学]