恩替卡韦联合扶正化瘀片治疗乙肝肝硬化代偿期患者的临床效果(1)
[摘要]目的 探討恩替卡韦联合扶正化瘀片治疗乙肝肝硬化代偿期患者的临床效果。方法 回顾性分析我院2015年6月～2016年5月收治的78例乙肝肝硬化代偿期患者的临床资料，采用随机数字表法分为两组，每组各39例。对照组采用恩替卡韦分散片治疗，治疗组则在对照组的基础上联合扶正化瘀片治疗，两组均连续治疗1年并随访3个月。分别测定两组治疗前后的肝功能指标、血清肝纤维化指标；行腹部彩超观察治疗前后的门静脉主干直径、脾脏厚度变化，行FibroScan测定并记录治疗前后的肝硬度值(Stiffne值)；统计两组治疗后HBeAg及HBV DNA转阴率；比较两组治疗后的Child-Pugh评分及不良反应发生情况。结果 除对照组的清蛋白(ALB)指标外，两组治疗后1年及随访3个月的丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBil)、ALB等肝功能指标及透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PCIII)、Ⅳ型胶原(Ⅳ-C)等血清肝纤维化指标均较治疗前明显改善(P<0.05)，治疗后治疗组上述各指标均明显优于同期对照组(P<0.05)；另两组治疗后的门静脉主干直径、脾厚度、Stiffne值均较治疗前明显缩小，治疗后治疗组改善程度明显好于对照组(P<0.05)。治疗组治疗后的HBV DNA阴转率89.74%明显高于对照组的66.67%，Child-Pugh评分较对照组明显降低，差异均有统计学意义(P<0.05)，但两组治疗后的HBeAg阴转率比较，差异无统计学意义(P>0.05)。两组治疗期间、治疗后均未发生严重不良反应情况。结论 恩替卡韦联合扶正化瘀能明显改善乙肝肝硬化代偿期患者的肝功能，有效抑制甚至逆转肝纤维化的进展，相对单用恩替卡韦治疗临床疗效更佳，预后更为稳定，值得临床推广应用。
[关键词]恩替卡韦；扶正化瘀；乙肝肝硬化代偿期；肝纤维化；肝功能
[中图分类号] R575.2 [文献标识码] A [文章编号] 1674-4721(2018)6(b)-0152-04
Clinical effect of Entecavir combined with Fuzheng Huayu Tablets in the treatment of liver cirrhosis compensatory patients
CHEN Xing
First Department of Infection，Public Health Hospital of Yangjiang City，Guangdong Province，Yangjiang 529500，China
[Abstract]Objective To investigate the clinical effect of Entecavir combined with Fuzheng Huayu Tablets in the treatment of decompensated hepatitis B patients.Methods The clinical data of 78 patients with decompensated hepatitis B from June 2015 to May 2016 in our hospital were retrospectively analyzed.The patients were divided into two groups (n=39) by random number table method.The patients in the control group were treated with Entecavir Dispersible Tablets.The patients in the treatment group were treated with Fuzheng Huayu Tablets on the basis of the control group.Both groups were treated for 1 year and were followed up for 3 months.The liver function indexes and serum liver fibrosis indexes were measured before and after treatment in both groups.The diameter of main portal vein and the spleen thickness before and after treatment were observed with abdominal ultrasonography.FibroScan was used to measure and record the liver cirrhosis(Stiffne value) before and after treatment.The negative rate of HBeAg and HBV DNA in both groups were calculated.The Child-Pugh scores and adverse reactions were compared between the two groups after treatment.Results The indexes of ALT，AST，TBil，ALB and other indexes of serum liver fibrosis of HA，LN，PCⅢand Ⅳ-C in two groups after 1 year of treatment and 3 months of follow-up were significantly lower than those in the control group(P<0.05).After treatment，the above indexes in the treatment group were significantly better than those in the control group(P<0.05).The other two groups were significantly better than the treatment group before significantly reduced after treatment，the treatment group improved significantly better than the control group(P<0.05).The negative conversion rate of HBV DNA after treatment in treatment group was 89.74%，66.67% in control group，and Child-Pugh score was significantly lower than that in control group，the differences were statistically significant(P<0.05).But there was no statistical difference in the negative conversion rate of HBeAg between the two groups (P>0.05).During the treament and after treatment of two groups，no serious adverse reactions occurred.Conclusion Entecavir combined with Fuzhenghuayu can significantly improve liver function in patients with decompensated hepatitis B and effectively inhibit or even reverse the progress of liver fibrosis.Compared with Entecavir alone，the clinical efficacy is better and the prognosis is more stable，which is worthy of clinical application., 百拇医药(陈兴)
[关键词]恩替卡韦；扶正化瘀；乙肝肝硬化代偿期；肝纤维化；肝功能
[中图分类号] R575.2 [文献标识码] A [文章编号] 1674-4721(2018)6(b)-0152-04
Clinical effect of Entecavir combined with Fuzheng Huayu Tablets in the treatment of liver cirrhosis compensatory patients
CHEN Xing
First Department of Infection，Public Health Hospital of Yangjiang City，Guangdong Province，Yangjiang 529500，China
[Abstract]Objective To investigate the clinical effect of Entecavir combined with Fuzheng Huayu Tablets in the treatment of decompensated hepatitis B patients.Methods The clinical data of 78 patients with decompensated hepatitis B from June 2015 to May 2016 in our hospital were retrospectively analyzed.The patients were divided into two groups (n=39) by random number table method.The patients in the control group were treated with Entecavir Dispersible Tablets.The patients in the treatment group were treated with Fuzheng Huayu Tablets on the basis of the control group.Both groups were treated for 1 year and were followed up for 3 months.The liver function indexes and serum liver fibrosis indexes were measured before and after treatment in both groups.The diameter of main portal vein and the spleen thickness before and after treatment were observed with abdominal ultrasonography.FibroScan was used to measure and record the liver cirrhosis(Stiffne value) before and after treatment.The negative rate of HBeAg and HBV DNA in both groups were calculated.The Child-Pugh scores and adverse reactions were compared between the two groups after treatment.Results The indexes of ALT，AST，TBil，ALB and other indexes of serum liver fibrosis of HA，LN，PCⅢand Ⅳ-C in two groups after 1 year of treatment and 3 months of follow-up were significantly lower than those in the control group(P<0.05).After treatment，the above indexes in the treatment group were significantly better than those in the control group(P<0.05).The other two groups were significantly better than the treatment group before significantly reduced after treatment，the treatment group improved significantly better than the control group(P<0.05).The negative conversion rate of HBV DNA after treatment in treatment group was 89.74%，66.67% in control group，and Child-Pugh score was significantly lower than that in control group，the differences were statistically significant(P<0.05).But there was no statistical difference in the negative conversion rate of HBeAg between the two groups (P>0.05).During the treament and after treatment of two groups，no serious adverse reactions occurred.Conclusion Entecavir combined with Fuzhenghuayu can significantly improve liver function in patients with decompensated hepatitis B and effectively inhibit or even reverse the progress of liver fibrosis.Compared with Entecavir alone，the clinical efficacy is better and the prognosis is more stable，which is worthy of clinical application., 百拇医药(陈兴)