柔肝化纤颗粒联合核苷类抗病毒药物治疗乙型肝炎失代偿期肝硬化患者的效果观察  

Clinical observation of Rougan Huaxian granule combined with nucleoside antiviral drugs in treatment of patients with decompensated cirrhosis of hepatitis B

作　　者：尚华 张国顺 吴贵恺 吴迪杨 王柳青 魏红山[5] Shang Hua;Zhang Guoshun;Wu Guikai;Wu Diyang;Wang Liuqing;Wei Hongshan(Department of Blood Purification,Tangshan Infectious Disease Hospital,Hebei Province,Tangshan 063000,China;Department of Gastroenterology,Affiliated Hospital to North China University of Science and Technology,Tangshan 063000,China;Department of Gastroenterology,Tangshan Workers'Hospital,Hebei Province,Tangshan 063000,China;Department of Gastroenterology,Hongci Hospital,Hebei Province,Tangshan 063000,China;Department of Gastroenterology,Beijing Ditan Hospital,Beijing,100015,China)

机构地区：[1]河北省唐山市传染病院血液净化科,唐山063000 [2]华北理工大学附属医院消化内科,唐山063000 [3]河北省唐山市工人医院消化科,唐山063000 [4]唐山市弘慈医院消化科,唐山063000 [5]北京地坛医院消化内科,北京100015

出　　处：《中国综合临床》2022年第1期53-61,共9页Clinical Medicine of China

基　　金：中国肝炎防治基金会资助项目(TQGB20170015);河北省医学科学研究课题计划项目(20210375)。

摘　　要：目的探讨柔肝化纤颗粒联合核苷类抗病毒药物对乙型肝炎失代偿期肝硬化患者肝肾功能、门静脉系统血流动力学、血管活性、抗病毒指标及对天冬氨酸氨基转移酶-血小板比值指数(aspartate aminotransferase-platelet ratio index,APRI)的影响。方法采用病例对照研究方法,收集2017年6月至2019年12月于唐山市传染病院和华北理工大学附属医院住院的乙型肝炎失代偿期肝硬化患者150例。应用计算机随机数字法分为对照组和观察组,每组各75例。对照组给予常规护肝和抗病毒治疗;观察组在对照组治疗的基础上加用柔肝化纤颗粒。观察两组患者的肝肾功能、门静脉系统血流动力学、血管活性、抗病毒指标及对APRI的变化。计量资料的两组间比较采用独立样本t检验,同组间治疗前后比较采用配对t检验,计数资料采用χ^(2)检验。结果两组患者性别、年龄、肝硬化病程、肝功能Child分级、治疗前各项指标基数资料比较差异均无统计学意义(均P>0.05)。治疗后两组患者丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、门静脉内径(diameter of portal vein,Dpv)、脾静脉内径(diameter of splenic vein,Dsv)、内皮素1、一氧化氮、胰高血糖素(glucagon,GLA)、APRI均较治疗前降低;组间比较,观察组ALT(51.60±15.97)U/L、AST(62.65±26.28)U/L、尿素氮(10.25±1.65)mmol/L、肌酐(78.54±14.09)μmol/L、Dpv(10.20±1.10)mm、Dsv(8.08±0.68)mm、内皮素1(31.93±6.35)ng/L、一氧化氮(41.38±8.06)μg/L、GLA(69.54±12.14)mg/L、APRI 3.14±1.35明显低于对照组[(97.49±30.87)U/L、(96.03±25.63)U/L、(17.49±2.55)mmol/L、(116.43±22.77)μmol/L、(13.42±1.26)mm、(10.44±0.83)mm、(44.34±11.88)ng/L、(63.47±15.50)μg/L、(107.11±25.29)mg/L、5.91±1.93],差异均有统计学意义(t值分别为11.43、7.87、20.64、12.26、16.62、18.99、7.98、10.96、11.60、10.23,均P<0.05)。治疗后两组Objective To explore the effects of Rougan Huaxian Granules combined with nucleoside antiviral drugs on liver and kidney function,portal hemodynamics,vascular activity,antiviral indexes and aspartate transaminase-platelet ratio index in patients with hepatitis B decompensated cirrhosis.Methods A case-control study was conducted on 150 patients with hepatitis B decompensated cirrhosis who were hospitalized in Tangshan Infectious Disease Institute and Affiliated Hospital of North China University of Science and Technology from June 2017 to December 2019 were enrolled.The patients were divided into control group and observation group by computer random random number method,with 75 cases in each group.The control group was given routine liver protection and antiviral treatment;the observation group was given Rougan Huaxian granules on the basis of the control group treatment.Observe the changes of liver and kidney function,portal vein system hemodynamics,vascular activity,antiviral index and aspartate transaminase-platelet ratio index in the two groups.Independent sample T test was used to compare the measurement data between the two groups,paired T test was used for comparison between the same groups before and after treatment,andχ^(2) test was used for counting data.Results There were no significant differences in gender,age,course of cirrhosis,Child grade of liver function and baseline data of indexes before treatment between 2 groups(ALL P>0.05).After treatment,alanine aminotransferase(ALT),aspartate aminotransferase(AST),urea nitrogen,creatinine,diameter of portal vein(Dpv),diameter of splenic vein(Dsv),endothelin-1,nitric oxide,glucagon(GLA),APRI,were all lower than before treatment.Comparison between groups,observation group ALT(51.60±15.97)U/L,AST(62.65±26.28)U/L,urea nitrogen(10.25±1.65)mmol/L,creatinine(78.54±14.09)μmol/L,Dpv(10.20±1.10)mm,Dsv(8.08±0.68)mm,endothelin-1(31.93±6.35)ng/L,nitric oxide(41.38±8.06)μg/L,GLA(69.54±12.14)mg/L,APRI(3.14±1.35),were significantly lower than those of contro

关 键 词：柔肝化纤颗粒 核苷类抗病毒药物 门静脉系统血流动力学 血管活性 天冬氨酸氨基转移酶-血小板比值指数 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]