关键词: 肝硬化, 乙型肝炎, 恩替卡韦, 复方鳖甲软肝片, 疗效, 转归

Abstract: Objective To investigate the efficacy of entecavir（ETV） and Fufang Biejiaruanganpian,a Chinese herbal medicine compound,combination therapy in patients with hepatitis B-induced liver cirrhosis. Methods 76 patients with hepatitis B liver cirrhosis were recruited in our hospital between January 2014 and December 2016. The patients with liver cirrhosis were randomly divided into control group （n=36） and observation group（n=40）,receiving ETV or ETV and Fufang Biejiaruangan combination therapy,and all patients were followed-up for 12 months. Serum HBV DNA loads were detected by PCR,and serum HA,PⅢP,LN and CⅣ levels were assayed routinely. All patients received Fibroscan check-up. Results At the end of 12 month observation,serum bilirubin and ALT levels in the observation group were （19.7±13.4） μmol/L and （28.3±9.4） U/L,much lower than [（23.2±13.8） μmol/L and （53.6±10.2）U/L,P<0.05] in the control,and serum albumin level was （37.2±5.6） g/L,prothrombin time activity （PTA） was （91.1±11.2）%,much higher than [（34.7±6.1）g/L and （81.4±10.5）%,P<0.05] in the control;the CTP score was （6.3±1.2）,much lower than [（8.1±1.4）,P<0.05] in the control,and liver stiffness measurement （LSM） was（16.5±12.2） kPa,also much lower than [（22.7±14.4）kPa,P<0.05] in the control;serum HA level was （89.2±43.1） μg/L,PⅢP level was （119.7±60.8） μg/L,LN level was （98.7±30.2） μg/L,and CⅣ level was （102.6±29.7） μg/L,significantly lower than [（184.3±58.2） μg/L,（254.5±74.7） μg/L,（140.8±39.7） μg/L,and （165.7±41.2） μg/L,respectively,P<0.05] in the control;serum HBV DNA loss was 97.5%（39/40）,and it was 94.4% （34/36） in the control,without significant difference between the two groups（P>0.05）,and serum HBV DNA load was（3.2±0.3） log10 copies/ml,no significant difference as compared to（3.5±0.4） log10 copies/ml in the control（P>0.05）;the incidences of ascites,hepatic encephalopathy,gastrointestinal bleeding and hepatocellular carcinoma in the observation group were 17.5%,5.0%,10.0% and 2.5%,much lower than 52.7%,13.8%,16.7% and 11.1% （P<0.05） in the control;no one in the observation group but three patients（8.3%） in the control died within the 12 month observation. Conclusion The combination of ETV and Fufang Biejiaruangan compound therapy in patients with hepatitis B-induced liver cirrhosis might improve liver functions,alleviate liver cirrhosis,and improve the prognosis,which needs further and long-term investigation.

Key words: Liver cirrhosis, Hepatitis B, Fufang Biejiaruangan compound, herbal medicine, Efficacy, Prognosis