实用肝脏病杂志 ›› 2026, Vol. 29 ›› Issue (1): 21-24.doi: 10.3969/j.issn.1672-5069.2026.01.006

• 病毒性肝炎 • 上一篇    下一篇

富马酸替诺福韦二吡呋酯联合复方甘草酸苷片治疗慢性乙型肝炎患者疗效研究*

孙雷, 陈雅倩, 曹智, 董淦功   

  1. 221300 江苏省徐州市 徐州医科大学附属邳州人民医院药学部(孙雷,陈雅倩,曹智);感染病科(董淦功)
  • 收稿日期:2025-09-18 出版日期:2026-01-10 发布日期:2026-02-04
  • 作者简介:孙雷,男,43岁,大学本科,副主任药师。E-mail:sl665122@163.com
  • 基金资助:
    *江苏省徐州市科技局卫生人才培养计划项目(编号:xz1262753)

Tenofovir disoproxil fumarate and compound glycyrrhizin combination therapy in patients with chronic hepatitis B

Sun Lei, Chen Yaqian, Cao Zhi, et al   

  1. Department of Pharmacy, Pizhou People's Hospital, Affiliated to Xuzhou Medical University, Xuzhou 221300,Jiangsu Province, China
  • Received:2025-09-18 Online:2026-01-10 Published:2026-02-04

摘要: 目的 观察富马酸替诺福韦二吡呋酯(TDF)联合复方甘草酸苷片治疗慢性乙型肝炎(CHB)患者的疗效。方法 2021年6月~2024年6月我院诊治的CHB患者94例,被随机分为对照组47例和观察组47例,分别给予TDF或TDF联合复方甘草酸苷片治疗观察48周。采用PCR法检测血清HBV DNA载量,采用电化学发光法检测血清HBeAg和HBsAg水平,采用化学发光法检测血清透明质酸(HA)、层粘连蛋白(LN)、IV型胶原(C-Ⅳ)和III型前胶原(PC-Ⅲ),采用ELISA法检测血清白细胞介素(IL)-6 IL-8和肿瘤坏死因子(TNF)-α水平。结果 在治疗48周末,两组血清HBV DNA均转阴,但两组血清HBeAg和HBsAg水平无显著性变化;观察组血清HA、LN和PC-Ⅲ水平分别为(175.2±21.9)ng/mL、(160.1±20.3)ng/mL和(147.4±18.4)ng/mL,均显著低于对照组【分别为(281.3±35.2)ng/mL、(229.4±28.7)ng/mL和(170.1±21.3)ng/mL,P<0.05】;观察组血清ALT和AST水平分别为(32.6±2.8)U/L和(28.4±4.1)U/L,均显著低于对照组【分别为(50.3±3.6)U/L和(44.2±4.3)U/L,P<0.05】;观察组血清IL-6、IL-8和TNF-α水平分别为(11.8±1.5)μg/L、(4.3±1.0)μg/L和(20.6±2.6)μg/L,均显著低于对照组【分别为(18.1±2.3)μg/L、(6.0±1.1)μg/L和(38.1±4.8)μg/L,P<0.05】。结论 应用TDF联合复方甘草酸苷片治疗CHB患者能够有效促进肝功能指标恢复,可能与其帮助抑制肝纤维化进展和降低了细胞因子反应有关。

关键词: 慢性乙型肝炎, 富马酸替诺福韦二吡呋酯, 复方甘草酸苷, 治疗

Abstract: Objective The aim of this study was to investigate tenofovir disoproxil fumarate (TDF) and compound glycyrrhizin combination therapy in patients with chronic hepatitis B (CHB). Methods 94 patients with CHB were enrolled in our hospital between June 2021 and June 2024, and were randomly assigned to receive oral TDF therapy in control (n=47), or receive oral TDF and compound glycyrrhizin combination therapy for 48 weeks. Serum HBV DNA loads were detected by PCR, serum HBeAg and HBsAg levels were assayed by electrochemiluminescence, serum HA, LN, C-IV and PC-III levels were detected by chemiluminescence, and serum IL-6, IL-8 and TNF-α were determined by ELISA. Results By end of 48-week treatment, serum HBV DNA loads became undetectable and HBeAg and HBsAg levels didn’t changed statistically differently in the two groups; serum HA, LN and PC-Ⅲ levels in the combination group were (175.2±21.9)ng/mL, (160.1±20.3)ng/mL and (147.4±18.4)ng/mL, all significantly lower than [(281.3±35.2)ng/mL, (229.4±28.7)ng/mL and (170.1±21.3)ng/mL, respectively, P<0.05] in the control; serum ALT and AST levels were (32.6±2.8)U/L and (28.4±4.1)U/L, both much lower than [(50.3±3.6)U/L and (44.2±4.3)U/L, respectively, P<0.05] in the control; serum IL-6, IL-8 and TNF-α levels were (11.8±1.5)μg/L, (4.3±1.0)μg/L and (20.6±2.6)μg/L, all much lower than [(18.1±2.3)μg/L, (6.0±1.1)μg/L and (38.1±4.8)μg/L, respectively, P<0.05] in the control group. Conclusion TDF in combination with compound glycyrrhizin in treatment of patients with CHB is efficacious, with improvement of serum liver function tests, which might be related to inhibition of liver fibrosis and reduced cytokine reactions.

Key words: Hepatitis B, Tenofovir disoproxil fumarate, Compound glycyrrhizin, Therapy