ABSTRACT
OBJECTIVE:To observe clinical efficacy and safety of Danning tablets combined with endoscopic ligation in the treatment of esophageal varices in patients with nonalcoholic fatty liver cirrhosis(NFLC). METHODS:A total of 70 NFLC patients with esophageal varices in our hospital during Sept. 2015-Sept. 2016 were divided into control group and observation group by simple random sampling method,with 35 cases in each group. Both groups received endoscopic ligation. Control group was given Somatostatin for injection with intravenous pump at the speed of 250 μg/h for 72 h after surgery,and Pantoprazole sodium enteric-coated capsules 40 mg,qd. Observation group was additionally given Danning tablets 1 g,tid,on the basis of control group. Both groups were given medicine for consecutive 4 weeks.The situation of ligation and clinical efficacies were observed in 2 groups,and the grading of esophageal varices before and after treatment,the occurrence of re-bleeding events and ADR were observed. RESULTS:The patients of 2 groups completed ligation successfully,there was no statistical significance in the times of ligation between 2 groups(P>0.05). Total response rate of observation group was 91.43%,which was significantly higher than 74.29% of control group,with statistical significance(P<0.05).Before treatment,there was no statistical significance in the grading of esophageal varices between 2 groups(P>0.05). One month and three months after treatment,the grading of esophageal varices in 2 groups were significantly better than before treatment,and observation group was significantly better than control group,with statistical significance(P<0.05). There was no statistical significance of 2 groups between 3 months after treatment and one month after treatment(P>0.05).Total incidence of re-bleeding events in observation group was 14.29% within 3-month follow-up,which was significantly lower than 40.00% of control group,with statistical significance(P<0.05). There was no statistical significance in the total incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Danning tablets combined with endoscopic ligation show significant therapeutic efficacy for esophageal varices of NFLC,significantly mitigate the degree of esophageal varices and reduce the incidence of re-bleeding without increasing the occurrence of ADR.
ABSTRACT
Objective Alprostadil can improve the clinical efficacy of the treatment of hepatitis B cirrhosis, but little literature is available about its effect on serum inflammatory factors in patients with hepatitis B cirrhosis.This study aimed to investigate the effect of alprostadil on serum inflammatory factors and liver function of the patients with hepatitis B cirrhosis and its possible action mechanisms.Methods We equally randomized 162 cases of hepatitis B cirrhosis admitted to our hospital from August 2014 to July 2015 into a control and an observation group, the former treated by conventional antiviral, liver-protecting and supportive therapies, and the latter with alprostadil in addition, both for 4 weeks.Then, we obtained the serum inflammatory factors, the contents of serum interleukin-6 (IL-6), high sensitive C reactive protein (hs-CRP) and tumor necrosis factor alpha (TNF-α) as well as such liver function indexes as glutamic-pyruvic transaminase (ALT), total bilirubin (TBil) and prothrombin activity (PTA), and compared them between the two groups before and after treatment.Results After 4 weeks of treatment, the effectiveness rate was significantly higher in the observation than in the control group (82.72% vs 62.96%, P<0.05).Compared with the baseline, the patients in the observation group showed significant improvement after treatment in serum IL-6 ([275.62±43.39] vs [97.15±19.73] pg/mL, P<0.05), hs-CRP ([425.54±55.58] vs [50.23±6.69] ng/L, P<0.05), TNF-α ([321.74±80.73] vs [85.45±13.61] pg/mL, P<0.05), ALT ([139.54±37.36] vs [96.13±23.62] μmol/L, P<0.05), TBil ([395.39±41.13] vs [271.55±25.12] μmol/L, P<0.05), and PTA ([38.50±4.19] vs [68.36±8.11]%), and the improvement was significantly better than in the control group (P<0.05).Conclusion Alprostadil helps alleviate the inflammatory condition, improve the liver function, and promote clinical efficacy in patients with hepatitis B cirrhosis.