Clinical Study Of Tenofovir Alafenamide Fumarate Tablets In The Treatment Of Compensated Hepatitis B Cirrhosis With Diabetes Menllitus

Objective:The purpose of this study is to observe and analyze the clinical effect of tenofovir alafenamide fumarate tablets(TAF)antiviral therapy in patients with compensated stage of Hepatitis B cirrhosisand diabetes mellitus(DM),and to explore the clinical treatment plan of such patients,so as to provide better clinical treatment plan for such patients.Methods:The patients admitted to the sixth People’s Hospital of Qingdao and Weifang Hospital of traditional Chinese medicine from January 2018 to December 2020 were selected.All the patients included in the study had been diagnosed with hepatitis B cirrhosis and diabetes mellitus,a total of 120 patients.In addition to basic treatment and symptomatic treatment,the three groups were given novorax 30 R to control blood glucose,TAF group was treated with enofovir alafenamide fumarate tablets(25mg qd);ETV group was treated with entecavir(ETV)(0.5mg qd)and TDF group was treated with tenofovir disoproxil fumarate tablets(TDF)(300mg qd),with 40 patients in each group.The clinical data of patients before treatment and 48 weeks after treatment were compared to evaluate the clinical efficacy of the three drugs.Result:1.Before treatment,the three groups of patients in Alanine aminotransferase(ALT)、Total Bilirubin(TBi L)、Albumin(ALB)、Fasting Blood Glucose(FBG)、Hemoglobin A1C(Hb A1C)、Serum Creatinine(SCr)、Blood Urea Nitrogen(BUN)、Cystatin C(Cys-C)、HBV-DNA quantitative laboratory related indicators,no statistical significance(P> 0.05).2.After 48 weeks of treatment,the average values of ALT,TBIL,HBV-DNA were significantly lower than those before treatment,and the average values of ALB were significantly higher than those before.3.After 48 weeks of treatment,the average values of ALT,TBIL and ALB in TAF group and TDF group were lower than those in ETV group,and the average values of Alb in TAF group and TDF grup were higher than those in ETV group,with statistical significance(P < 0.05).There was no statistical significance in alt,TBL,ALB and HBV-DNA in TAF group and TDF group(P > 0.05).The average value of Cys-C in TAF group was significantly lower than that in ETV group There was statistical significance between TDF group and control group(P < 0.05).4.After 48 weeks of treatment,the FPG,Hb A1 c,BUN,SCr and other indicators of the three groups were not statistically significant.5.No serious adverse reactions occurred during the treatment.Conclusion:Compared with ETV,TAF has better anti Hepatitis B Virus(HBV)effect,better liver function and less adverse effects on renal function.Compared with TDF,TAF has a lower dose of oral administration,targeted distribution characteristics,in the case of its anti HBV efficacy does not change,significantly reduce its toxic effect on the kidney,better meet the requirements of patients with compensated stage of Hepatitis B cirrhosis and diabetes mellitus for renal function protection.As a new anti HBV drug,TAF provides a better choice for patients with compensated stage of Hepatitis B cirrhosis and diabetes mellitus.