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目的探索阿德福韦酯胶囊与复方鳖甲软肝片联合治疗早期乙肝肝硬化的疗效。方法83例早期乙肝肝硬化患者随机分为阿德福韦酯胶囊与复方鳖甲软肝片联合治疗组及阿德福韦酯胶囊组,每月查肝功等生化指标,每3个月检测乙肝两对半定量(化学发光法)、HBV-DNA(荧光定量PCR法),38例患者治疗前及治疗12个月后行肝穿刺病理活组织检查。结果12个月后联合治疗组及阿德福韦酯胶囊组肝功能均明显恢复,两组比较差异无统计学意义;前者HBeAg阴转率、HBeAg/HBeAb血清转换率均高于后者(χ2值分别为4.36与5.84,P均<0.05)、HBVDNA阴转更为显著(χ2值为34.56,P<0.005);联合治疗组肝组织炎性反应活动度、纤维化程度改善更明显(t值分别为3.30、2.75,P均<0.05)。结论阿德福韦酯胶囊与复方鳖甲软肝片联合治疗组将抗乙肝病毒与抗肝纤联合起来,在抗乙肝病毒、改善肝脏炎性反应及抗肝纤维化等方面均优于单用阿德福韦酯胶囊组,是治疗早期乙肝肝硬化有效的联合方案。
Objective To explore the efficacy of adefovir dipivoxil capsule and Fufang Biejia Ruangan Tablet in the treatment of early-stage hepatitis B cirrhosis. Methods Eighty-three patients with early-stage hepatitis B cirrhosis were randomly divided into adefovir dipivoxil capsules and Fufang Biejia Ruangan Tablet combined therapy group and adefovir dipivoxil capsule group. The biochemical indexes such as liver function were checked every month and detected every 3 months Two pairs of semi-quantitative hepatitis B (chemiluminescence), HBV-DNA (fluorescence quantitative PCR method), 38 patients before treatment and after 12 months of liver biopsy biopsy. Results After 12 months, the liver function of the combination therapy group and the adefovir dipivoxil capsule group were significantly recovered. There was no significant difference between the two groups. The seroconversion rates of HBeAg and HBeAg / HBeAb in the former group were higher than the latter (χ2 (P <0.05). The negative conversion of HBVDNA was more significant (χ2 = 34.56, P <0.005). The activity of inflammatory reaction and the degree of fibrosis in the combination group were more obvious (t value Respectively, 3.30,2.75, P <0.05). Conclusion Combination of adefovir dipivoxil capsule and Fufang Biejia Ruangan Pian combines the anti-hepatitis B virus and anti-liver fiber and is better than anti-hepatitis B virus, anti-hepatitis B virus, anti-hepatic inflammation and anti-liver fibrosis Adefovir dipivoxil capsule group, is the treatment of early hepatitis B cirrhosis effective joint program.