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目的:观察肝康Ⅱ号对E抗原阳性慢性乙型肝炎患者硫化氢(H2S)浓度的影响。方法:106例慢性乙型肝炎肝纤维化患者随机数字法分为治疗组和对照组。治疗组给予阿德福韦酯联合肝康Ⅱ号,对照组给予阿德福韦酯联合安络化纤丸,治疗周期48周。另设健康对照组。观察临床症状体征变化,综合评价治疗效果。比较治疗前后HBV DNA、乙肝标志物、肝纤维化指标、H2S水平。结果:(1)综合评价:治疗组治愈41例(治愈率77.36%),好转12例(好转率22.64%);对照组治愈40例(治愈率75.47%),好转13例(好转率24.53%);治疗组、对照组均无无效病例;两组比较无显著差异(P>0.05)。(2)乙肝病毒载量、乙肝血清标志物:治疗48周,治疗组HBV DNA阴转率92.45%(49/53),对照组HBV DNA阴转率90.56%(48/53),两组无显著差异(P>0.05)。治疗组E抗原阴转率15.09%(8/53);对照组E抗原阴转率16.98%(9/53),比较无显著差异(P>0.05)。(3)肝纤维化指标:治疗后治疗组、对照组HA、LN、PCⅢ、cⅣ低于治疗前,比较有显著差异(P<0.01);两组比较无显著差异(P>0.05)。(4)H2S变化:两组治疗后与治疗前比较血H2S浓度上升,比较有显著差异(P<0.05);治疗后治疗组与对照组比较,无统计学差异(P>0.05)。(5)肝功能变化:两组治疗后肝功能(ALT、AST、GGT、TBil、DBIL)下降,与治疗前比较均有显著差异(P<0.01);两组比较无显著差异(P>0.05)。结论:肝康Ⅱ号对E抗原阳性慢性乙型肝炎H2S浓度下降具有抑制作用。
Objective: To observe the effect of Gankang Ⅱ on the concentration of hydrogen sulfide (H2S) in E antigen-positive chronic hepatitis B patients. Methods: 106 patients with chronic hepatitis B liver fibrosis were randomly divided into treatment group and control group. The treatment group was treated with adefovir dipivoxil combined with Gan Kang Ⅱ, while the control group was given adefovir dipivoxil combined with Anluo Huaxian Pills. The treatment period was 48 weeks. Another set of healthy control group. Observation of clinical signs and symptoms, a comprehensive evaluation of the treatment effect. Before and after treatment compared HBV DNA, hepatitis B markers, liver fibrosis indicators, H2S levels. Results: (1) The comprehensive evaluation: The treatment group was cured in 41 cases (cure rate 77.36%), improved in 12 cases (improvement rate 22.64%); control group 40 cases cured (cure rate 75.47%), improved in 13 cases (improvement rate 24.53% ). There was no significant difference in the treatment group and the control group between the two groups (P> 0.05). (2) Hepatitis B viral load and hepatitis B serum markers: After 48 weeks of treatment, the HBV DNA negative conversion rate was 92.45% (49/53) in the treatment group and 90.56% (48/53) in the control group, with no Significant difference (P> 0.05). The negative rate of E antigen in the treatment group was 15.09% (8/53), while the negative rate of E antigen in the control group was 16.98% (9/53), with no significant difference (P> 0.05). (3) The indexes of liver fibrosis: The HA, LN, PCⅢ and cⅣ in the treatment group and control group after treatment were lower than those before treatment (P <0.01). There was no significant difference between the two groups (P> 0.05). (4) The changes of H2S: There was significant difference (P <0.05) between the two groups in blood H2S concentration after treatment and before treatment; there was no significant difference between the two groups after treatment (P> 0.05). (5) The changes of liver function: There was significant difference of liver function (ALT, AST, GGT, TBil, DBIL) between the two groups before treatment (P <0.01) ). Conclusion: Gokang Ⅱ inhibits the decrease of H2S concentration in E antigen positive chronic hepatitis B patients.