关键词: 西藏地区, 富马酸丙酚替诺福韦, 扶正化瘀片, 乙型肝炎肝硬化代偿期

Abstract: Objective To investigate the difference between the efficacy of propofol tenofovir fumarate (TAF) combined with Fuzheng Huayu Tablet (FZHY) and TAF alone in compensated patients with hepatitis B-related cirrhotic patients in Xizang. Methods The clinical data of 60 patients with compensatory hepatitis B cirrhosis were analyzed and divided into two groups with 30 patients in each group according to random number table method. The control group was treated with TAF, and the study group was treated with TAF combined with FZHY. The treatment course of both groups was 24 weeks. The liver biochemical indexes, serum liver fibrosis indexes, HBV DNA negative conversion rate, liver hardness and incidence of adverse reactions were compared between the two groups before and after treatment. Results ALT, AST and TBil levels in both of the control group and study group were significantly decreased after 24 weeks of treatment compared with those of before treatment (AST levels of the control group before/after treatment: 51.97±3.77 U/L/25.93±1.19 U/L; AST levels of the study group before/after treatment: 49.23±3.29 U/L/25.80±1.01 U/L; ALT levels of the control group before/after treatment: 55.17±3.48 U/L/30.83±1.52 U/L; ALT levels of the study group before/after treatment: 53.26±1.98U/L/24.87±2.68 U/L; TBil levels of the control group before/after treatment: 17.10±1.23 μmol/L/14.33±1.18 μmol/L; TBil levels of the study group before/after treatment: 19.03±3.16 μmol/L/16.63±3.2 μmol/L), but Alb levels were not significantly increased after treatment (Alb levels of the control group before/after treatment: 35.65±0.57 g/L/37.23±0.51 g/L; Alb levels of the study group before/after treatment: 35.44±0.33 g/L/38.10±0.51 g/L). HA, LN, PCⅢ and Ⅳ-C in both groups decreased significantly after treatment compared with those of before treatment (HA levels in the control group before/after treatment: 293.47±8.66 ng/mL/259.20±8.83 ng/mL; HA levels in the study group before/after treatment: 296.77±9.10 ng/mL/215.57±9.07 ng/mL; LN levels in the control group before/after treatment: 193.23±6.34 ng/mL/125.87±6.98 ng/mL; LN levels in the study group before/after treatment: 192.23±7.57 ng/mL/91.80±4.12 ng/mL; PCⅢ levels in the control group before/after treatment: 251.07±11.60 ng/mL/199.10±8.13 ng/mL; PCⅢ levels in the study group before/after treatment: 252.07±10.60 ng/mL/123.02±6.38 ng/mL; Ⅳ-C levels in the control group before/after treatment: 243.30±8.09 ng/mL/192.23±7.57 ng/mL, Ⅳ-C levels in the study group before/after treatment: 249.93±8.02 ng/mL/139.67±3.45 ng/mL; P<0.05). The decrease values of the study group after treatment were significantly higher than those of the control group (P<0.05).There was no significant difference in the negative HBV DNA conversion rate between the two groups at before and after 24 weeks of treatment (χ²=0.150, P=0.698). After 24 weeks of treatment, the liver hardness level in both groups decreased compared with that of before treatment (13.03±0.35/11.69±0.36 in control group and 13.67±0.35/9.73±0.44 in study group), and the decrease was more significant in control group (P<0.05). The incidence of adverse reactions in the control group and the study group was 6.67% and 10%, respectively, with no significant difference between the two groups (χ²=0.218, P=1.000). Conclusion TAF combined with FZHY can improve liver hardness better than TAF alone in patients with liver cirrhosis in compensatory stage, suggesting that it can inhibit or reverse liver cirrhosis more effectively.

Key words: Tibet, Fumaric acid propofol tenofovir, Fuzheng huayu tablets, Compensated period of hepatitis B cirrhosis