CAJ | 학술논문

目的：探讨阿德福韦酯（ADV）联合安络化纤丸治疗慢性乙型肝炎患者的临床疗效。方法选择2012年4月至2013年4月滨州市中心医院结防院收治的85例慢性乙型肝炎患者作为研究对象，按随机数字表分为研究组43例和对照组42例。对照组采用阿德福韦酯（10 mg/次，1次/d，口服）治疗，研究组在此基础上加用安络化纤丸（6 g/次，3次/d，口服）治疗，治疗48周后比较两组患者 HBV DNA 转阴率、肝功能变化情况、血清纤维化指标变化情况以及肝组织纤维化和炎症活动度积分。结果研究组 HBV DNA 转阴率为90.69%（39/43），对照组为85.71%（36/42），差异无统计学意义（χ2=0.142，P>0.05）。治疗后两组患者总胆红素（TBil）、谷草转氨酶（AST）和谷丙转氨酶（ALT）、Ⅳ型胶原蛋白、层粘连蛋白和透明质酸血清水平均明显下降，与治疗前比较差异均有统计学意义（均 P<0.05）。其中治疗后研究组Ⅳ型胶原蛋白、层粘连蛋白和透明质酸血清水平较对照组低，差异有统计学意义（P<0.05）。治疗后研究组纤维化积分低于对照组，差异有统计学意义（P<0.05）。结论安络化纤丸和 ADV 联合用药可明显改善抗纤维化效果，延缓肝组织纤维化进程。
목적：탐토아덕복위지（ADV）연합안락화섬환치료만성을형간염환자적림상료효。방법선택2012년4월지2013년4월빈주시중심의원결방원수치적85례만성을형간염환자작위연구대상，안수궤수자표분위연구조43례화대조조42례。대조조채용아덕복위지（10 mg/차，1차/d，구복）치료，연구조재차기출상가용안락화섬환（6 g/차，3차/d，구복）치료，치료48주후비교량조환자 HBV DNA 전음솔、간공능변화정황、혈청섬유화지표변화정황이급간조직섬유화화염증활동도적분。결과연구조 HBV DNA 전음솔위90.69%（39/43），대조조위85.71%（36/42），차이무통계학의의（χ2=0.142，P>0.05）。치료후량조환자총담홍소（TBil）、곡초전안매（AST）화곡병전안매（ALT）、Ⅳ형효원단백、층점련단백화투명질산혈청수평균명현하강，여치료전비교차이균유통계학의의（균 P<0.05）。기중치료후연구조Ⅳ형효원단백、층점련단백화투명질산혈청수평교대조조저，차이유통계학의의（P<0.05）。치료후연구조섬유화적분저우대조조，차이유통계학의의（P<0.05）。결론안락화섬환화 ADV 연합용약가명현개선항섬유화효과，연완간조직섬유화진정。
Objective To evaluate the therapeutic effect of anluohuaxian capsule combined with adefovir dipivoxil(adefovir dipivoxil,ADV) on patients with chronic hepatitis B. Methods 85 cases ofpatients with chronic hepatitis B from April 2012 to April 2013 in our hospital were chosen to research. and were divided into control group and experimental group by random number table.The control group were treated with adefovir dipivoxil(10mg once time,once a day,oral),and experimental group were treated with anluohuaxian capsule(6g once time,three times a day,oral)on the basis of control group.After 48 weeks’treatment,the HBV DNA negative rate, changes of liver function,changes of serum fibrosis index,and liver fibrosis and inflammatory activity score between two group were compared.Results the HBV DNA negative rate of experimental group was 90.69%(39/43),and control group was 85.71%(36/42),difference had no significance( χ2 =0.142,P<0.05).AST,ALT,TBil, Ⅳ collagen albumen,laminin and hyaluronic acid levels in serum of two group were all decreased,difference had significance( P<0.05) compared to before treatment. Ⅳcollagen albumen,laminin and hyaluronic acid levels of experimental group were lower than control group after treatment,difference were significant(P<0.05).Fibrosis integral of experimental group was lower than control group,difference had significant significance(P<0.05). Conclusion Anluohuaxian capsule combined with adefovir dipivoxil can effectively improve anti fibrosis effects,delay the process of liver fibrosis.