| 引用本文:杨建辉，杨柳青，许增佳，黄丽娟，郭晓.替诺福韦酯联用十味诃子汤散对慢性乙型肝炎合并非酒精性脂肪肝患者肝功能的影响[J].世界中医药,2019,(09):. |
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| 替诺福韦酯联用十味诃子汤散对慢性乙型肝炎合并非酒精性脂肪肝患者肝功能的影响 |
| Effects of Tenofovir Disoproxil Combined with Shiwei Kezi Decoction Powder on Liver Function in Patients with Chronic Hepatitis B Complicated with Non-Alcoholic Fatty Liver Disease |
| 投稿时间：2019-05-22 |
| DOI：10.3969/j.issn.1673-7202.2019.09.044 |
| 中文关键词: 替诺福韦酯 十味诃子汤散 慢性乙型肝炎 非酒精性脂肪肝 肝功能 |
| English Keywords:Tenofovir dipivoxil powder Shiwei Hezi Decoction Powder Chronic hepatitis B Non-alcoholic fatty liver Liver function |
| 基金项目:广东省科技计划基金资助项目（2016F020212331）；河源市社会发展科技计划项目(170608110221309) |
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| 中文摘要: |
| 目的:探讨替诺福韦酯联用十味诃子汤散对慢性乙型肝炎（CHB）合并非酒精性脂肪肝（NAFL）患者肝功能的影响。方法:选取2017年10月至2018年10月河源市人民医院收治的CHB合并NAFL患者100例作为研究对象，按照随机数字表法分为对照组和观察组，每组50例。对照组给予替诺福韦酯治疗，观察组在对照组的基础上采用十味诃子汤散治疗，2组均治疗12周。比较2组治疗前后肝功能指标、血脂指标水平、肝脏超声情况及HBV-DNA载量；观察比较2组患者不良反应发生情况。结果:治疗后2组患者血清中总胆红素（TBIL）、天门冬氨酸氨基转移酶（AST）及谷丙转氨酶（ALT）水平均明显下降，且观察组明显低于对照组；白蛋白（ALB）水平明显升高，观察组明显高于对照组，差异有统计学意义（P<0.05）；与治疗前比较，治疗后2组患者血清中高脂血症(TG)、总胆固醇(TC)和低密度脂蛋白-胆固醇(LDL-C)水平明显下降，且观察组明显低于对照组；高密度脂蛋白胆固醇(HDL-C)水平明显升高，且观察组显著高于对照组，差异有统计学意义（P<0.05）；与治疗前比较，治疗后2组患者脾静脉内径、门静脉内径及脾厚度水平明显下降，但观察组明显小于对照组；2组肝右最大流速（Vmax）明显升高，且观察组明显高于对照组，差异有统计学意义（P<0.05）；与治疗前比较，治疗后观察组平均HBV-DNA载量水平明显低于和与对照组（P<0.05）；治疗后观察组临床治疗有效率94.00%显著高于对照组76.00%（P<0.05）。2组患者不良反应发生率比较，差异无统计学意义（P>0.05）。结论：十味诃子汤散联合替诺福韦酯治疗CHB合并NAFL疗效较好，可有效改善患者血脂及肝功能水平。 |
| English Summary: |
| To explore the effects of tenofovir dipivoxil combined with Shiwei Hezi Decoction Powder on liver function in patients with chronic hepatitis B(CHB)complicated with non-alcoholic fatty liver disease(NALFD).Methods:A total of 100 patients with CHB complicated with NALFD were selected from October 2017 to October 2018.They were divided into a control group(n=50)and an observation group(n=50)according to the random number table method.The control group was treated with tenofovir dipivoxil,while the observation group was treated with Shiwei Hezi Decoction Powder on the basis of the control group.Both groups were treated for 12 weeks.The liver function index,blood lipid index,liver ultrasonography and HBV-DNA load were compared before and after treatment in the 2 groups,and the adverse reactions were observed and compared in the 2 groups.Results:Compared with before treatment,the serum levels of TBIL,AST and ALT in the observation group after treatment were significantly lower than those in the control group,and the levels of ALB were significantly higher than those in the control group(P<0.01); Compared with before treatment,the serum levels of TG,TC and LDL-C in the observation group after treatment were significantly lower than those in the control group,and the levels of HDL-C in the observation group were significantly higher than those in the control group(P<0.01).Compared with before treatment,after treatment,the splenic vein diameter,portal vein diameter and spleen thickness in the observation group were significantly lower than those in the control group,and the right hepatic Vmax was significantly higher than that in the control group(P<0.01); compared with before treatment,the average HBV-DNA load in the observation group was significantly lower than that in the control group(P<0.05); after treatment,the total clinical effective rate of the observation group was 94.00%,significantly higher than that in the control group was 76.00%(P<0.05).There was no significant difference in the incidence of adverse reactions between the 2 groups(P>0.05).Conclusion:Shiwei Hezi Decoction Powder combined with tenofovir dipivoxil is effective in treating chronic hepatitis B complicated with non-alcoholic fatty liver disease,which can effectively improve the blood lipid level and liver function of patients. |
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