替诺福韦联合异甘草酸镁对CHB患者肝功能与免疫系统的影响及药学评价  

Effects of tenofovir combined with magnesium isoglycyrrhizinate on liver function and immune system in patients with CHB and pharmaceutical evaluation

作　　者：冯艳[1] 缪应祥[1] 陈敏[1] FENG Yan;MIAO Ying-Xiang;CHEN Min(Nantong Third Hospital Affiliated to Nantong University,Nantong 226006,China)

机构地区：[1]南通大学附属南通第三医院,江苏南通226006

出　　处：《中国处方药》2022年第11期99-101,共3页Journal of China Prescription Drug

摘　　要：目的探讨替诺福韦与异甘草酸镁在慢性乙型肝炎(CHB)患者中的联合应用,对CHB患者肝功能与免疫系统的影响,并做药学评价。方法对2018年2月~2020年6月医院肝病科收治的126例CHB患者,按照给予不同的用药治疗模式将患者分为观察组与对照组,每组63例。两组患者在接受常规治疗的基础上,对照组给予口服替诺福韦,观察组患者在对照组患者口服替诺福韦的基础上静脉给予异甘草酸镁治疗。同时干预12周后,比较两组患者的(1)临床疗效;(2)肝功能相关指标[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)与总胆红素(TBil)];(3)肝纤维化相关指标[透明质酸(HA)、层黏蛋白(LN)与Ⅳ型胶原(Ⅳ-C)];(4)免疫系统相关指标(CD4+、CD8+与CD4+/CD8+)。结果两组患者在12周不同模式的干预后,观察组患者的总治疗有效率(96.83%)显著高于对照组患者(73.02%)(P<0.05);两组患者肝功能三项指标较治疗前均有所改善(P<0.05),但观察组患者的改善程度要显著优于对照组患者(P<0.05);两组患者肝纤维化的三项指标较治疗前均有所改善(P<0.05),但观察组患者的改善程度要显著优于对照组患者(P<0.05);两组患者免疫系统的三项指标较治疗前均有所改善(P<0.05),但观察组患者的改善程度要显著优于对照组患者(P<0.05)。结论CHB患者联合使用替诺福韦与异甘草酸镁,能够更好地提高临床疗效,较单一使用替诺福韦更好的改善肝功能相关指标,并且对患者的肝纤维化指标与免疫功能有改善作用,联合使用保肝药物异甘草酸镁的用药效果优于单用替诺福韦。Objective To investigate the combined application of tenofovir and magnesium isoglycyrrhizinate in patients with chronic hepatitis B(CHB)and its effects on liver function and immune system in patients with CHB.Methods 126 patients with CHB treated in the department of liver diseases of the hospital from February 2018 to June 2020 were divided into observation group and control group according to different drug treatment modes,with 63 cases in each group.On the basis of routine treatment,the patients in the control group were given oral tenofovir,and the patients in the observation group were given intravenous magnesium isoglycyrrhizinate on the basis of oral tenofovir in the control group.After 12 weeks of intervention,indexes of the two groups were compared:the clinical effects;(2)Liver function related indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBil)];(3)Liver fibrosis related indexes[hyaluronic acid(HA),laminin(LN)and type IV collagen(Ⅳ-C)];(4)Immune system related indexes(CD4+,CD8+and CD4+/CD8+).Result The total effective rate of the observation group(96.83%)was significantly higher than that of the control group(73.02%)(P<0.05);The three indexes of liver function in the two groups were improved compared with those before treatment(P<0.05),but the degree of improvement in the observation group was significantly better than that in the control group(P<0.05);The three indexes of liver fibrosis in the two groups were improved compared with those before treatment(P<0.05),but the degree of improvement in the observation group was significantly better than that in the control group(P<0.05);The three indexes of immune system in the two groups were improved compared with those before treatment(P<0.05),but the degree of improvement in the observation group was significantly better than that in the control group(P<0.05).Conclusion After giving the combination of tenofovir and magnesium isoglycyrrhizinate to CHB patients,it can better improve the clinical efficacy,better i

关 键 词：联合用药 替诺福韦 异甘草酸镁 肝功能 免疫功能 

分 类 号：R512.62[医药卫生—内科学] R969.3[医药卫生—临床医学]