摘要
目的 探究富马酸丙酚替诺福韦联合肝爽颗粒治疗慢性乙肝肝纤维化疗效及对患者免疫功能和炎症状态的影响。方法 选择2018年10月至2021年10月于延安市人民医院就诊的122例慢性乙肝肝纤维化患者,采用单双球法随机分为对照组(采用富马酸丙酚替诺福韦治疗)和观察组(采用富马酸丙酚替诺福韦联合肝爽颗粒治疗)各61例。比较两组患者治疗前和治疗6个月后肝功能指标[血胆红素(TBil)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、白球比例(A/G)]、血清肝纤维化指标[透明质酸(HA)、层黏连蛋白(LN)、Ⅳ型胶原(CⅣ)、Ⅲ前胶原(PCⅢ)]、肝脏硬度值、细胞免疫功能指标(CD4^(+)T细胞、CD4^(+)/CD8^(+)T细胞、CD8^(+)T细胞、CDl6^(+)/CD56^(+)NK细胞)和炎症因子水平[炎症因子转化生长因子-β_(1)(TGF-β_(1))、超敏C反应蛋白(hs-CRP)、基质金属蛋白酶-2 (MMP-2)、白细胞介素-6(1L-6)];同时比较两组患者治疗期间的不良反应发生情况。结果 治疗6个月后,观察组患者的血清TBil、ALT、AST、HA、LN、CⅣ、PCⅢ、TGF-β_(1)、hs-CRP、MMP-2、1L-6水平及肝脏硬度值明显低于对照组,差异均有统计学意义(P<0.05);治疗6个月后,观察组患者的A/G、CD4^(+)、CD4^(+)/CD8^(+)、CDl6^(+)/CD56^(+)NK值分别为1.03±0.09、(40.12±7.05)%、1.84±0.34、(18.59±6.06)%,明显高于对照组的0.89±0.07、(35.72±6.64)%、1.42±0.31、(15.31±4.12)%,差异均有统计学意义(P<0.05);两组患者治疗期间均无明显不良反应。结论 富马酸丙酚替诺福韦与肝爽颗粒联合治疗慢性乙肝肝纤维化患者可抑制肝纤维化,提高免疫力,缓解炎症反应,改善患者肝功能。
Objective To explore the efficacy of tenofovir alafenamide fumarate combined with Ganshuang granules in the treatment of chronic hepatitis B with liver fibrosis and its effects on the immune function and inflammato-ry status of patients.Methods A total of 122 patients with chronic hepatitis B and liver fibrosis who were treated in Yan'an People's Hospital from October 2018 to October 2021 were selected,which were randomly divided into the con-trol group(treated with tenofovir alafenamide fumarate)and observation group(treated with tenofovir alafenamide fuma-rate combined with Ganshuang granules)by the odd-even ball method,with 61 patients in each group.The liver function indicators[blood bilirubin(TBil),alanine aminotransferase(ALT),aspartate aminotransferase(AST),ratio of albumin to globulin(A/G)],indicators of serum liver fibrosis[hyaluronic acid(HA),laminin(LN),typeⅣcollagen(CⅣ),typeⅢprocollagen(PCⅢ)],liver stiffness value,cellular immune function indicators(CD4^(+)T cell,CD4^(+)/CD8^(+)T cell,CD8^(+)T cell,CD16^(+)/CD56^(+)NK cell),and inflammatory factors[transforming growth factor-β_(1)(TGF-β_(1)),high-sensitivity C-reactive protein(hs-CRP),matrix metalloproteinase-2(MMP-2),interleukin-6(IL-6)]before treatment and after 6 months of treatment,and occurrence of adverse reactions during treatment were compared between the two groups.Results After 6 months of treatment,the levels of serum TBil,ALT,AST,HA,LN,CⅣ,PCⅢ,TGF-β_(1),hs-CRP,MMP-2,IL-6,and liver stiffness value in the observation group were significantly lower than those in the control group(P<0.05);the A/G,CD4^(+),CD4^(+)/CD8^(+),and CDl6^(+)/CD56^(+)NK were 1.03±0.09,(40.12±7.05)%,1.84±0.34,and(18.59±6.06)%in the observation group,significantly higher than 0.89±0.07,(35.72±6.64)%,1.42±0.31,and(15.31±4.12)%in the control group;the differences were statistically significant(P<0.05).There were no significant differences in adverse reactions between the two groups during treatment.Conclusion The combination of tenofovir alafenamide fumarate and Ganshuang granules can inhibit the liver fibrosis,enhance the immunity,relieve the inflammatory response,and im-prove the liver function of patients with chronic hepatitis B complicated with liver fibrosis.
作者
赵媛
曹耀章
李小鹏
ZHAO Yuan;CAO Yao-zhang;LI Xiao-peng(Department of Infectious Diseases,Department of Pharmacy,Yan'an 716000,Shaanxi,CHINA;Department of Infectious Diseases,Yan'an People's Hospital,Yan'an 716000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2023年第10期1383-1387,共5页
Hainan Medical Journal
基金
陕西省延安市科技攻关项目(编号:2017KS—04)。
关键词
慢性乙肝
肝纤维化
肝爽颗粒
富马酸丙酚替诺福韦
肝功能
免疫功能
炎症因子
Chronic hepatitis B
Liver fibrosis
Ganshuang granules
Tenofovir alafenamide fumarate
Liver function
Immune function
Inflammatory factors
