Chinese medicine Jiangganlong combined with anti-virus medicine in long-term treatment of active liver cirrhosis and its effect on prognosis of patients
- Author:
- No author available
- Journal Title:
- WORLD CHINESE JOURNAL OF DIGESTOLOGY
- Issue:
- 29
- DOI:
- 10.3969/j.issn.1009-3079.2006.29.008
- Key Word:
- 降肝隆;拉米夫定;阿德福韦酯;活动性肝硬变;乙型肝炎;YMDD变异;病死率;生存时间
Abstract： 目的:观察降肝隆联合抗病毒治疗活动性肝炎肝硬变(ALC)114例的长期疗效及对预后的影响.方法:随机选择ALC 114例,分为治疗组和对照组.治疗组:降肝隆煎剂1付/3 d或丸剂4.0 g,3次/d,LAM 0.1 g/d,YMDD变异后加用ADV联合中药的治疗,待HBV DNA阴转后停用LAM,ADV联合中药继续治疗;对照组:中成药如复方鳖甲软肝片、或大黄蜇虫丸等抗纤维化治疗、降酶,对症治疗.两组均可予以支持,感染、出血、肝性脑病等合并症的对症处理相同.平均疗程36.0 mo.结果:治疗组与对照组HBV DNA总阴转率分别为75.4%(43/57)、3.5%(2/57),两组相比有显著差异(P＜0.01).治疗组YMDD变异率为40.4%(23/57),YMDD变异后,3例未加用ADV,肝功能衰竭而死亡;加用ADV治疗20例,HBV DNA变异病毒阴转率90%(18/20).治疗组的HBeAg(+)阴转率为44.4%(16/36),和对照组16.7%(5/30)相比差异显著(P＜0.05).治疗组患者的TBIL、ALT的复常率均明显优于对照组,治疗后白蛋白明显升高,Child-Pugh积分下降,肝功能失代偿例数明显减少,合并症的发生率14.0%(8/57)和对照组50.8%(29/57)相比有明显差异(P＜0.01).治疗组的死亡率为7.0%(4/57),对照组为29.8%(17/57),两组相比差异显著(P＜0.01).治疗组中失代偿肝硬变的生存时间显著长于对照组(3.3±2.1 a vs 1.1±1.0 a,P＜0.01).结论:中药降肝隆联合LAM抗病毒药治疗ALC,病毒复制受到抑制,患者的肝功能持续改善,减少了合并症的发生,降低了ALC的病死率,延长了患者的生存时间,改善了ALC患者的预后,且未见肾功能损伤.
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