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多烯磷脂酰胆碱胶囊辅助治疗慢性乙型肝炎有效性的真实世界研究
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| 篇名： | 多烯磷脂酰胆碱胶囊辅助治疗慢性乙型肝炎有效性的真实世界研究 |
| TITLE： | Real-world study on the efficacy of Polyene phosphatidylcholine capsules as adjunctive therapy for chronic hepatitis B |
| 摘要： | 目的 评价多烯磷脂酰胆碱胶囊（PPC）辅助治疗慢性乙型肝炎（CHB）的有效性。方法回顾性收集2017年1月1日－2022年12月31日于四川省医学科学院·四川省人民医院门诊就诊并诊断为CHB，使用保肝药物联合抗病毒药物治疗或单独使用抗病毒药物治疗，且在门诊进行长期随访的患者资料。通过倾向性评分匹配的方法平衡混杂因素后，比较真实医疗条件下PPC联合抗病毒方案对比单纯抗病毒治疗方案（即PPC+抗病毒组对比抗病毒组）、PPC+甘草酸二铵肠溶胶囊（DGC）联合抗病毒治疗方案对比DGC联合抗病毒治疗方案（即PPC+DGC+抗病毒组对比DGC+抗病毒组）治疗CHB的有效性。结果最终纳入在抗病毒治疗方案基础上使用保肝药物的CHB患者382例（使用DGC、PPC、两药联合方案的分别有221、63、98例）和单纯抗病毒治疗的患者400例。经倾向性评分匹配后，PPC+抗病毒组和抗病毒组患者各有47例；治疗后，PPC+抗病毒组患者的丙氨酸转氨酶（ALT）水平较同组治疗前和同期抗病毒组均显著降低（P＜0.05），而两组患者的ALT复常率比较差异无统计学意义（P＞0.05）。PPC+DGC+抗病毒组和DGC+抗病毒组患者各有74例；治疗后，两组患者的ALT水平均较同组治疗前显著降低，且PPC+DGC+抗病毒组患者的ALT水平显著低于同期DGC+抗病毒组，ALT复常率显著高于DGC+抗病毒组（P＜0.05）。结论在使用抗病毒药物治疗CHB的基础上，联合PPC辅助治疗具有明显的降酶优势；此外，与DGC联合抗病毒方案相比，DGC与PPC的双保肝药物联合抗病毒方案在保肝和降酶方面的效果更优。 |
| ABSTRACT： | OBJECTIVE To evaluate the effectiveness of Polyene phosphatidylcholine capsules （PPC） as adjuvant therapy for chronic hepatitis B （CHB）. METHODS Retrospective data were collected from the patients diagnosed with CHB， treated with hepatoprotective drugs combined with antiviral drugs or antiviral drugs alone， and underwent long-term follow-up in the outpatient department of Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital from January 1， 2017 to December 31， 2022. After balancing confounding factors through propensity score matching， the effectiveness of PPC combined with antiviral therapy versus antiviral therapy alone （PPC+antiviral group versus antiviral group） and PPC+Diammonium glycyrrhizinate enteric- coated capsules （DGC） combined with antiviral therapy versus DGC combined with antiviral therapy （PPC+DGC+antiviral group versus DGC+antiviral group） as therapy for CHB were compared under real medical conditions. RESULTS Totally 382 patients with CHB who received hepatoprotective agents based on antiviral therapy （221， 63 and 98 patients who received DGC， PPC and combination therapy， respectively） and 400 patients who received antiviral therapy alone were ultimately included. After propensity score matching， there were 47 patients each in the PPC+antiviral group and the antiviral group， respectively； after treatment， the alanine transaminase （ALT） levels in the PPC+antiviral group were significantly reduced compared to before treatment and the antiviral group at the same time （P＜0.05）， while there was no statistically significant difference in the ALT normalization rate between the two groups （P＞0.05）. There were 74 patients each in the PPC+DGC+antiviral group and the DGC+antiviral group， respectively； after treatment， the ALT levels of patients in both groups were significantly reduced compared to before treatment， the ALT levels of PPC+DGC+antiviral group were significantly lower than those in the DGC+antiviral group at the same time， and the ALT normalization rate was significantly higher in the PPC+DGC+antiviral group than that in the DGC+antiviral group （P＜0.05）. CONCLUSIONS Based on using antiviral drugs to treat CHB， adjuvant therapy combined with PPC has a significant advantage in reducing liver enzymes； in addition， compared with the DGC combined antiviral regimen， the dual hepatoprotective drug of DGC and PPC combined with an antiviral regimen has better effects on liver protection and reduction of liver enzymes. |
| 期刊： | 2024年第35卷第20期 |
| 作者： | 朱宝强；胡琪；刘强；王美丁；龙恩武 |
| AUTHORS： | ZHU Baoqiang，HU Qi，LIU Qiang，WANG Meiding，LONG Enwu |
| 关键字： | 多烯磷脂酰胆碱胶囊；保肝药物；慢性乙型肝炎；丙氨酸转氨酶；倾向性评分匹配；真实世界研究 |
| KEYWORDS： | Polyene phosphatidylcholine capsule； hepatoprotective drug； chronic hepatitis B； alanine transaminase； propensity |
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