关键词: 慢性乙型肝炎, 恩替卡韦, 六味五灵片, 细胞因子, 治疗

Abstract: Objective The aim of this study was to investigate the efficacy of entecavir and Liuwei Wuling tablets, an herbal medicine, in treating patients with chronic hepatitis B (CHB). Methods 79 patients with CHB were encountered in our hospital between May 2021 and May 2024, and were randomly assigned to receive entecavir treatment in 39 cases as a control, or receive combination of entecavir and the herbal medicine in 40 cases for 48 week treatment. Serum hepatitis B viral markers were detected by chemiluminescence, serum HBV DNA loads were detected by real-time fluorescent polymerase chain reaction, serum hyaluronic acid (HA), laminin (LN), type III procollagen (PCIII) and type IV collagen (IV-C) levels were determined by radioimmunoassay, and serum transforming growth factor-β1 (TGF-β1), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) levels were assayed by ELISA. Results By end of 48-week treatment, serum HBV DNA negative rates in the two groups were not significantly different (97.5% vs. 94.9%, P>0.05);serum ALT and AST levels in the combination group were (32.5±5.6)U/L and (30.3±3.9)U/L, both much lower than [(47.6±7.3)U/L and (44.7±5.1)U/L, respectively, P<0.05] in the control; serum HA, LN, PCⅢ and Ⅳ-C levels were (88.9±16.4)ng/mL, (87.8±12.7)ng/mL, (84.8±13.2)ng/mL and (82.7±11.4)ng/mL, all significantly lower than [(121.1±20.4)ng/mL, (115.2±15.3)ng/mL, (106.2±17.7)ng/mL and (102.3±14.3)ng/mL, respectively, P<0.05] in the control group; serum TGF-β1, TNF-α and IL-6 levels were (26.2±5.3)ng/mL, (22.1±4.4)pg/mL and (17.5±3.1)pg/mL, all much lower than [(37.5±7.2)ng/mL, (33.7±6.1)pg/mL and (25.6±5.0)pg/mL, respectively, P<0.05] in the control. Conclusion Entecavir in combination with Liuwei Wuling tablets could help improve liver function tests normal, which might be duo to inhibition of liver fibrosis and inflammatory reactions in patients with CHB.

Key words: Hepatitis B, Entecavir, Liuwei Wuling tablets, an herbal medicine, Cytokines, Therapy