目的 探討舒肝寧注射液聯(lián)合富馬酸替諾福韋二吡呋酯片治療慢性乙型肝炎肝硬化的臨床療效。方法 選取2019年1月—2020年2月在平煤神馬醫(yī)療集團(tuán)總醫(yī)院就診的104例慢性乙型肝炎肝硬化患者作為本研究對象，根據(jù)隨機(jī)數(shù)字表法將104例患者分為對照組和治療組，每組各52例。對照組口服富馬酸替諾福韋二吡呋酯片，300 mg/次，1次/d。治療組在對照組治療的基礎(chǔ)上肌肉注射舒肝寧注射液，10 mL/次，1次/d。兩組均連續(xù)治療4周后。觀察兩組患者的臨床療效，比較兩組的肝功能指標(biāo)、淋巴細(xì)胞、乙型肝炎病毒的脫氧核糖核酸（HBV-DNA）轉(zhuǎn)陰率、乙型肝炎E抗原（HBeAg）轉(zhuǎn)陰率、乙型肝炎E抗體（HBeAb）轉(zhuǎn)陽率。結(jié)果 治療后，治療組患者的總有效率為96.15%，對照組總有效率為84.62%，兩組對比差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組的丙氨酸氨基轉(zhuǎn)移酶（ALT）、天冬氨酸氨基轉(zhuǎn)移酶（AST）、總膽紅素（TBIL）水平顯著降低，白蛋白（ALB）水平顯著升高（P<0.05）；治療后治療組的ALT、AST、TBIL水平低于對照組，ALB水平高于對照組（P<0.05）。治療后，兩組的CD3⁺、CD4⁺、CD4⁺/CD8⁺、NK細(xì)胞顯著升高（P<0.05）；治療后治療組的CD3⁺、CD4⁺、CD4⁺/CD8⁺、自然殺傷（NK）細(xì)胞高于對照組（P<0.05）。治療后，治療組的HBeAg轉(zhuǎn)陰率、HBeAb轉(zhuǎn)陽率低于對照組（P<0.05），兩組的HBV-DNA轉(zhuǎn)陰無明顯差異。結(jié)論 舒肝寧注射液聯(lián)合富馬酸替諾福韋二吡呋酯片治療慢性乙型肝炎肝硬化的臨床療效較好，可改善肝功能，調(diào)節(jié)淋巴細(xì)胞的分泌。

Objective To investigate the clinical effect of Shuganning Injection combined with Tenofovir Disoproxil Fumarate Tablets in treatment of chronic hepatitis B cirrhosis. Methods Patients (104 cases) with chronic hepatitis B cirrhosis in Pingmei Shenma Medical Group General Hospital from January 2019 to February 2020 were randomly divided into control and treatment groups, and each group had 52 cases. Patients in the control group were po administered with Tenofovir Disoproxil Fumarate Tablets, 300 mg/time, once daily. Patients in the treatment group were iv administered with Shuganning Injection on the basis of the control group, 10 mL/time, once daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and liver function indexes, lymphocyte, HBV-DNA negative rate, HBeAg negative rate, HBeAb positive rate in two groups were compared. Results After treatment, the total effective rate of the treatment group was 96.15%, and that of the control group was 84.62%, and there was difference between two groups (P<0.05). After treatment, the levels of ALT, AST, and TBIL in the two groups were significantly decreased, while the level of ALB in the two groups was significantly increased (P<0.05). After treatment, the levels of ALT, AST, and TBIL in the treatment group were lower than those in the control group, while the level of ALB was higher than those in the control group (P<0.05). After treatment, CD3⁺, CD4⁺, CD4⁺/CD8⁺, and NK cells in two groups were significantly increased (P<0.05). After treatment, CD3⁺, CD4⁺, CD4⁺/CD8⁺, and NK cells in the treatment group were higher than those in the control group (P< 0.05). After treatment, HBeAg negative conversion rate and HBeAb positive conversion rate in the treatment group were lower than those in the control group (P<0.05). There were no significant differences in the negative conversion rate of HBV-DNA between two groups. Conclusion Shuganning Injection combined with Tenofovir Disoproxil Fumarate Tablets has clinical curative effect in treatment of chronic hepatitis B cirrhosis, can improve liver function and regulate the secretion of lymphocytes.

R975

河南省醫(yī)學(xué)科技攻關(guān)計劃項目（201702338）