恩替卡韦与水飞蓟宾胶囊联合治疗慢性乙型肝炎患者临床效果分析

doi:10.3969/j.issn.1672-5069.2018.02.013

摘要/Abstract

摘要： 目的探讨恩替卡韦与水飞蓟宾胶囊联合治疗慢性乙型肝炎患者的临床效果。方法 2015年6月~2016年7月我院收治的140例慢性乙型肝炎患者,按照随机分组法将所有患者分为观察组（n=70)和对照组（n=70）。对照组患者口服恩替卡韦片治疗,在观察组,采用恩替卡韦片联合水飞蓟宾胶囊治疗。采用时间分辨免疫荧光法检测血清HBeAg,采用荧光定量PCR法检测血清HBV DNA,采用ELISA法检测血清白细胞介素-6 （IL-6）、TNF-α）和转化生长因子-β （TGF-β,使用FACSCalibur流式细胞仪检测外周血淋巴细胞亚群。结果在治疗24 w末,观察组临床症状如乏力、食欲不振、腹胀复常率分别为87.1%、90.0%、82.9%,显著高于对照组的41.4%、71.4%、58.6% （P<0.05）;观察组血清HBeAg和HBV DNA转阴率分别为0.0%和88.6%,与对照组的0.0%和68.6%比,无统计学差异（P>0.05）;观察组血清TBIL、ALT和AST水平分别为（16.49±3.17） μmol/L、（47.36±8.24） U/L和（40.58±5.26） U/L,显著低于对照组的（23.56±3.48） μmol/L、（68.25±7.93） U/L和（66.24±8.24） U/L（P<0.05）;观察组血清IL-6、TNF-α和TGF-β水平分别为（204.8±27.4） μg/L、（68.2±12.5） μg/L和（158.2±15.2） μg/L,显著低于对照组的（264.2±29.2） μg/L、（107.4±13.7） μg/L和（193.5±17.3） μg/L （P<0.05）;观察组外周血CD4+细胞百分比和CD4+/CD8+细胞比值分别为（40.36±3.61）%和（1.50±0.32）,显著高于对照组的【（33.46±3.17） %和（1.33±0.27）,P<0.05】。结论恩替卡韦片与水飞蓟宾胶囊联合治疗慢性乙型肝炎患者效果确切,可有效抑制HBV DNA复制,缓解机体炎症反应,提高患者的免疫功能。

关键词: 慢性乙型肝炎, 恩替卡韦片, 水飞蓟宾, 治疗

Abstract: Objective To explore the efficacy of entecavir and silibinin combination in the treatment of patients with chronic hepatitis B. Methods 140 patients with chronic hepatitis B were recruited in our hospital between June 2015 and July 2016,and the patients were divided into observation group （n=70） and control group （n=70） by a randomized grouping method. The patients in the control group was treated with entecavir,and the patients in the observation group was treated with entecavir combined with silibinin capsules. The clinical symptoms and signs,negative conversion rates of serum HBeAg and HBV DNA,liver function index,cytokine levels and peripheral blood T lymphocyte subsets were detected and compared between the two groups. Results At the end of 24 w treatment,the improvement of fatigue,anorexia and abdominal distension in the observation group were 87.1%,90%,82.9%,respectively,significantly higher than those in the control group （41.4%,71.4%,58.6%,P<0.05）;the negative rates of serum HBeAg and HBV DNA in the observation group were 0.0% and 88.6%,no statistical difference（P>0.05） as compared to 0.0% and 68.6% in the control group; serum TBIL,ALT and AST levels in the observation group were （16.49±3.17） μmol/L,（47.36±8.24） U/L and （40.58±5.26） U/L,significantly lower than （23.56±3.48） μmol/L,（68.25±7.93） U/L and （66.24±8.24） U/L in the control （P<0.05）;serum IL-6, TNF-α and TGF-β levels in the observation group were （204.8±27.4） μg/L,（68.2±12.5） μg/L and（158.2±15.2） μg/L, significantly lower than （264.2±29.2） μg/L,（107.4±13.7） μg/L and （193.5±17.3） μg/L in the control （P<0.05）;the peripheral blood CD4+ cells and ratio of CD4+/CD8+ in the observation group were （40.36±3.61） % and（1.50±0.32）,significantly higher than （33.46±3.17） % and （1.33±0.27） in the control（P<0.05）. Conclusion Entecavir combined with silibinin capsules in the treatment of patients with chronic hepatitis B have curative effect by the inhibition of HBV replication,relieving the inflammatory reactions,and improving the immune functions.

Key words: Hepatitis B, Entecavir, Silibinin, Therapy

梁守赞, 黄惠宜. 恩替卡韦与水飞蓟宾胶囊联合治疗慢性乙型肝炎患者临床效果分析[J]. 实用肝脏病杂志, 2018, 21(2): 208-211.

Liang Shouzan, Huang Huiyi. Efficacy of entecavir and silibinin combination in the treatment of patients with chronic hepatitis B[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2018, 21(2): 208-211.

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