恩替卡韦联合扶正化瘀片治疗乙型肝炎肝硬化患者疗效研究*

doi:10.3969/j.issn.1672-5069.2024.03.021

摘要/Abstract

摘要： 目的探讨恩替卡韦联合扶正化瘀片治疗乙型肝炎肝硬化患者的疗效。方法 2018年8月～2022年12月我院收治的乙型肝炎肝硬化患者122例,被随机分为对照组61例和观察组61例,分别给予恩替卡韦或恩替卡韦联合扶正化瘀片治疗52 w。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,使用Fibroscan 502型弹性测量仪行肝脏硬度检测(LSM)。结果在治疗52 w末,观察组血清HBV DNA转阴率为96.7%,与对照组的93.4%比,差异无统计学意义(P＞0.05),而血清ALT复常率为98.4%,显著高于对照组的85.2%(P＜0.05);观察组血清HBsAg和HBeAg水平分别为(826.1±152.6)IU/mL和(194.5±33.8)IU/mL,均显著低于对照组【分别为(1005.3±207.5)IU/mL和(245.6±51.5)IU/mL,P＜0.05】;观察组血清ALT、AST和LSM分别为(49.6±7.3)U/L、(39.2±6.1)U/L和(9.2±2.1)kPa,均显著低于对照组【分别为(66.9±10.7)U/L、(52.8±8.7)U/L和(11.8±3.0)kPa,P＜0.05】。结论应用恩替卡韦联合扶正化瘀片治疗乙型肝炎肝硬化患者在抗病毒的同时能帮助改善肝功能指标,减轻肝纤维化程度,值得临床进一步研究。

关键词: 肝硬化, 乙型肝炎, 恩替卡韦, 扶正化瘀片, 肝硬度检测, 治疗

Abstract: Objective The aim of this study was to investigate the efficacy of Chinese herbal medicine compound,Fuzheng Huayu table, in the treatment of patients with hepatitis B-induced liver cirrhosis (LC) undergoing entecavir treatment. Methods 122 patients with hepatitis B-induced LC were enrolled in our hospital between August 2018 and December 2022, and were randomly divided into control (n=61) and observation (n=61) group, receiving entecavir or entecavir and Fuzheng Huayu table combination therapy for 52 weeks. Serum HBV DNA loads were detected by PCR, serum HBeAg and HBsAg levels were quantitatively assayed electrochemiluminescence, and liver stiffness measurement was determined by Fibroscan 502. Results At the end of 52 week treatment, serum HBV DNA negative rate in the observation group was 96.7%, not significantly different as compared to 93.4% in the control (P＞0.05), while serum ALT normalization rate was 98.4%, much higher than 85.2%(P＜0.05) in the control; serum HBsAg and HBeAg levels in the combination-treated group were (826.1±152.6)IU/mL and (194.5±33.8)IU/mL, both significantly lower than [(1005.3±207.5)IU/mL and (245.6±51.5)IU/mL, respectively, P＜0.05] in the control; serum ALT, AST and the LSM in the observation group were (49.6±7.3)U/L, (39.2±6.1)U/L and (9.2±2.1)kPa, all significantly lower than [(66.9±10.7)U/L, (52.8±8.7)U/L and (11.8±3.0)kPa, respectively, P＜0.05] in the control group. Conclusion The auxiliary oral administration of Fuzheng Huayu capsule at base of entecavir antiviral therapy might ameliorate liver fibrosis in patients with hepatitis B-induced LC, and is worthy of further clinical investigation.

Key words: Liver cirrhosis, Hepatitis B, Entecavir, Fuzheng Huayu capsule, herbal medicine, Liver stiffness measurement, Therapy

李菊兰, 张华堂, 郑怡娟, 余雪平, 邓勇, 苏智军. 恩替卡韦联合扶正化瘀片治疗乙型肝炎肝硬化患者疗效研究^*[J]. 实用肝脏病杂志, 2024, 27(3): 402-405.

Li Julan, Zhang Huatang, Zheng Yijuan, et al. Chinese herbal medicine compound,Fuzheng Huayu table, ameliorate liver fibrosis in patients with hepatitis B-induced liver cirrhosis receiving entecavir antiviral treatment[J]. Journal of Practical Hepatology, 2024, 27(3): 402-405.

参考文献

[1] Lee SW, Choi J, Kim SU, et al. Entecavir versus tenofovir in patients with chronic hepatitis B: enemies or partners in the prevention of hepatocellular carcinoma. Clin Mol Hepatol, 2021, 27(3):402-412.
[2] Jeng WJ, Chien RN, Liaw YF. Fibrosis in patients with chronic hepatitis B and minimally raised ALT during tenofovir therapy. Lancet Infect Dis, 2021, 21(7):910-911.
[3] Huang LL, Yu XP, Ruan QF, et al. Liver stiffness measurement can predict liver inflammation in chronic hepatitis B Patients with normal alanine transaminase. J Clin Transl Hepatol, 2023, 11(4):817-826.
[4] Shoaib N, Khan Z, Ibrahim M, et al. Dyslipidemia and impaired liver function biomarkers in patients with hepatitis B liver cirrhosis. J Taibah Univ Med Sci, 2023, 18(4):748-754.
[5] Lin MJ, Su TH, Liu CJ, et al. Serum cytokine profiles predict outcomes of chronic hepatitis B patients discontinuing entecavir or tenofovir therapy. J Formos Med Assoc, 2023, 122(7):564-573.
[6] Liu Y, Guo W, Li M. Diammonium glycyrrhizinate preparation for liver function recovery in chronic hepatitis B in China: a meta-analysis with trial sequential analysis. Curr Pharm Des, 2022, 28(25):2089-2112.
[7] 叶晓婷, 孙庆丰, 付荣泉, 等. 瞬时弹性成像技术评估替诺福韦联合扶正化瘀片治疗乙型肝炎肝硬化患者疗效初步研究. 实用肝脏病杂志, 2021, 24(1):143-144.
[8] 中华医学会感染病学分会, 中华医学会肝病学分会. 慢性乙型肝炎防治指南(2019年版). 中华肝脏病杂志, 2019, 27(12):938-961.
[9] Surial B, Wyser D, Béguelin C, et al. Prevalence of liver cirrhosis in individuals with hepatitis B virus infection in sub-Saharan Africa: systematic review and meta-analysis. Liver Int, 2021, 41(4):710-719.
[10] Liao MJ, Li J, Dang W, et al. Novel index for the prediction of significant liver fibrosis and cirrhosis in chronic hepatitis B patients in China. World J Gastroenterol, 2022, 28(27):3503-3513.
[11] Wu Q, Mao W. New prognostic factor for hepatitis B virus-related decompensated cirrhosis: ratio of monocytes to HDL-cholesterol. J Clin Lab Anal, 2021, 35(11):e24007.
[12] Han Z, He X, Peng S. Neutrophil count to albumin ratio as a prognostic indicator for HBV-associated decompensated cirrhosis. J Clin Lab Anal, 2021, 35(4):e23730.
[13] Feld JJ, Wahed AS, Fried M, et al. Withdrawal of long-term nucleotide analog therapy in chronic hepatitis B: outcomes from the withdrawal phase of the HBRN immune active treatment trial. Am J Gastroenterol, 2023, 118(7):1226-1236.
[14] Cheng DY, Zhao ZM, Wan G, et al. Impact of fuzheng huayu tablet on antiviral effect of entecavir in patients with hepatitis B cirrhosis. Hepatobiliary Pancreat Dis Int, 2022, 21(5):479-484.
[15] Lee KC, Cheng JS, Chang ML, et al. Comparable outcomes of decompensated chronic hepatitis B patients treated with entecavir or tenofovir: an 8-year cohort study. Hepatol Int, 2022, 16(4):799-806.
[16] Liaw YF. Undesirable long-term outcome of entecavir therapy in chronic hepatitis B with cirrhosis. Clin Gastroenterol Hepatol, 2020, 18(9):2146-2147.
[17] De Benedetto I, Boglione L, Salvador E, et al. Plasmatic and intracellular concentration of entecavir during treatment of a symptomatic flare in HBV-HDV decompensated cirrhosis. J Infect Public Health, 2020, 13(2):315-316.
[18] Cheng DY, Zhao ZM, Wan G, et al. Impact of fuzheng huayu tablet on antiviral effect of entecavir in patients with hepatitis B cirrhosis. Hepatobiliary Pancreat Dis Int, 2022, 21(5):479-484.
[19] Kayadibi H, Yilmaz B, Ozgur Yeniova A, et al. Development and evaluation of a novel noninvasive index for predicting significant fibrosis, advanced fibrosis, and cirrhosis in patients with chronic hepatitis B infection. Eur J Gastroenterol Hepatol, 2021, 33(S1):e121-e130.
[20] Wang T, Zhou X, Liu H, et al. Fuzheng huayu capsule as an adjuvant treatment for HBV-related cirrhosis: a systematic review and meta-analysis. Phytother Res, 2018, 32(5):757-768.
[21] Wu QJ, Lyu WL, Li JM, et al. Yinqisanhuang jiedu decoction for the treatment of hepatitis B-related compensated liver cirrhosis: study protocol for a multi-center randomized controlled trial. Trials, 2021, 22(1):701.
[22] Yao L, Zhang J, Jin J,et al. An analysis of the efficacy and safety of compound glycyrrhizin injections in the treatment of drug-induced liver injury using a nationwide database. Int J Clin Pharm, 2022, 44(3):731-740.
[23] Sun X, Tan Y, Lyu J, et al. Active components formulation developed from fuzheng huayu recipe for anti-liver fibrosis. Chin J Integr Med, 2022, 28(6):538-544.

恩替卡韦联合扶正化瘀片治疗乙型肝炎肝硬化患者疗效研究^*

Chinese herbal medicine compound,Fuzheng Huayu table, ameliorate liver fibrosis in patients with hepatitis B-induced liver cirrhosis receiving entecavir antiviral treatment

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