本文選題：牛磺熊去氧膽酸膠囊 + 阿德福韋酯片�。� 參考：《現(xiàn)代藥物與臨床》2016年09期

【摘要】：目的探究熊去氧膽酸聯(lián)合阿德福韋酯和替比夫定治療失代償期乙型肝炎肝硬化的臨床療效。方法選擇2012年5月—2014年5月西安市第八醫(yī)院收治的失代償期乙型肝炎肝硬化患者128例作為研究對象,隨機(jī)分為對照組和治療組,每組各64例。對照組口服阿德福韋酯片,10 mg/次,1次/d;同時口服替比夫定片,600 mg/次,1次/d。治療組在對照組基礎(chǔ)上口服�；切苋パ跄懰崮z囊,10 mg/kg,3次/d。兩組患者均治療50周。觀察兩組的臨床療效,比較兩組抗病毒療效、肝功能指標(biāo)和Child-Pugh評分。結(jié)果治療后,對照組和治療組的總有效率分別為84.3%、85.9%,兩組比較差異無統(tǒng)計(jì)學(xué)意義;但是兩組顯著改善率分別為54.7%、68.7%,有效率分別為29.7%、17.2%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療后,兩組脫氧核糖核酸(HBV-DNA)轉(zhuǎn)陰率、乙型肝炎e抗原(HBe Ag)血清學(xué)轉(zhuǎn)換率、丙氨酸轉(zhuǎn)氨酶(ALT)復(fù)常率及病毒學(xué)突破率比較差異均無統(tǒng)計(jì)學(xué)意義。治療后,兩組白蛋白(ALB)和凝血酶原活動度(PTA)均顯著升高,而血清總膽紅素(TBIL)和ALT均顯著下降,同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義(P0.05);且治療組這些觀察指標(biāo)的改善程度明顯優(yōu)于對照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。治療后,兩組Child-Pugh評分均明顯降低,同組治療前后差異有統(tǒng)計(jì)學(xué)意義(P0.05);治療30周、40周和50周后,治療組Child-Pugh評分降低幅度比對照組同期更大,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論熊去氧膽酸聯(lián)合阿德福韋酯和替比夫定治療失代償期乙型肝炎肝硬化具有較好的臨床療效,能改善患者肝功能,降低Child-Pugh評分,具有一定的臨床推廣應(yīng)用價值。
[Abstract]:Objective to investigate the clinical efficacy of ursodeoxycholic acid combined with adefovir and tibivudine in the treatment of decompensated hepatitis B cirrhosis. Methods 128 patients with decompensated hepatitis B cirrhosis treated in Xi'an eighth Hospital from May 2012 to May 2014 were randomly divided into control group (n = 64) and treatment group (n = 64). The control group was treated with adefovir tablets for 10 mg/ d and tibivudine for 600 mg/ d. The treatment group took 10 mg / kg Taurodeoxycholic acid capsule on the basis of control group for 3 times / d. Both groups were treated for 50 weeks. The clinical efficacy of the two groups was observed, and the antiviral efficacy, liver function index and Child-Pugh score were compared between the two groups. Results after treatment, the total effective rates of the control group and the treatment group were 84.3 and 85.9, respectively. There was no significant difference between the two groups, but the improvement rates of the two groups were 54.7 and 68.7, respectively, and the effective rates were 29.7and 17.2.The differences between the two groups were statistically significant (P0.05). After treatment, there was no significant difference in the conversion rate of HBV-DNA, the serological conversion rate of hepatitis B e antigen (HBe Ag), the normalization rate of alanine aminotransferase (alt) and the virological breakthrough rate between the two groups. After treatment, albumin (ALB) and prothrombin activity (PTA) increased significantly, while serum total bilirubin (TBIL) and alt decreased significantly. The difference between the same group before and after treatment was statistically significant (P0.05), and the improvement of these observation indexes in the treatment group was significantly better than that in the control group, and the difference between the two groups was statistically significant (P0.05). After treatment, Child-Pugh scores in the two groups were significantly lower than those in the control group (P0.05). After 30 weeks and 50 weeks of treatment, the Child-Pugh score in the treatment group was significantly lower than that in the control group (P0.05). Conclusion ursodeoxycholic acid combined with adefovir dipivoxil and tibivudine are effective in the treatment of patients with decompensated hepatitis B cirrhosis and can improve liver function and reduce Child-Pugh score.
【作者單位】： 西安市第八醫(yī)院藥劑科;西安市第八醫(yī)院肝病科;西安市第八醫(yī)院化驗(yàn)室;
【分類號】：R512.62;R575.2

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