恩替卡韦联合扶正解毒散结方治疗乙型肝炎肝硬化患者疗效研究*

doi:10.3969/j.issn.1672-5069.2024.02.019

摘要/Abstract

摘要： 目的探讨应用恩替卡韦联合扶正解毒散结方治疗乙型肝炎肝硬化患者的疗效。方法 2020年9月～2022年9月我院诊治的乙型肝炎肝硬化患者112例, 被随机分为对照组56例和观察组56例, 分别给予恩替卡韦或恩替卡韦联合扶正解毒散结方治疗24 w。采用放射免疫分析法检测血清Ⅲ型前胶原(PC-Ⅲ)、层粘连蛋白(LN)、透明质酸(HA)和Ⅳ型胶原(Ⅳ-C), 使用彩色多普勒超声诊断仪检测脾脏厚度、脾静脉内径和门静脉内径, 使用肝脏瞬时弹性检测仪行肝脏硬度检测(LSM)。结果在治疗24 w末, 观察组ALT复常率为92.9%, 显著高于对照组的75.0%(P<0.05);观察组胁下积块、腹大坚满、胁痛如刺、面色晦黯、纳呆、口干苦和便溏等中医证候积分分别为(1.0±0.2)分、(1.2±0.3)分、(1.0±0.2)分、(0.9±0.2)分、(0.8±0.2)分、(0.9±0.2)分和(0.7±0.1)分, 均显著低于对照组【分别为(1.5±0.3)分、(1.7±0.4)分、(1.6±0.3)分、(1.5±0.2)分、(1.2±0.3)分、(1.4±0.3)分和(1.2±0.2)分, P＜0.05】;观察组血清ALT水平为(41.6±9.0)U/L, 显著低于对照组【(59.7±11.5)U/L, P＜0.05】;观察组血清PC-Ⅲ和HA水平分别为(106.4±17.9)μg/L和(122.3±15.6)μg/L, 均显著低于对照组【分别为(145.4±20.6)μg/L和(167.9±24.2)μg/L, P＜0.05】; 观察组脾脏厚度和LSM分别为(43.8±3.5)mm和(11.0±1.6)kPa, 均显著低于对照组【分别为(46.4±4.0)mm和(13.3±2.1)kPa, P＜0.05】。结论应用恩替卡韦联合扶正解毒散结方治疗乙型肝炎肝硬化患者能缓解临床症状, 改善肝功能, 抑制肝纤维化进展, 值得临床进一步研究。

关键词: 肝硬化, 乙型肝炎, 扶正解毒散结方, 恩替卡韦, 肝纤维化, 治疗

Abstract: Objective The aim of this study was to investigate the efficacy of entecavir and Fuzheng Jiedu Sanjie Decoction, a herbal compound, combination in the treatment of patients with hepatitis B-induced liver cirrhosis (LC). Methods A total of 112 patients with hepatitis B-induced LC were enrolled in our hospital between September 2020 and September 2022, and were divided randomly into control (n=56) and observation group (n=56), receiving entecavir or combination of entecavir and the herbal compound treatment for 24 weeks. Serum type-III procollagen (P-Ⅲ), laminin (LN), hyaluronic acid (HA) and type-IV collagen (Ⅳ-C) levels were detected by radioimmunoassay, the thickness of spleen, diameters of splenic vein and portal vein were detected by color Doppler ultrasonography and the liver stiffness measurement (LSM) was detected by FibroScan. Results At the end of 24 week treatment, the normalization rate of serum ALT level in the observation group was 92.9%, much higher than 75.0%(P<0.05) in the control; the traditional Chinese medicine (TCM) syndrome scores in the observation group decreased greatly, much superior to that in the control (P＜0.05); serum ALT level in the observation group was (41.6±9.0)U/L, significantly lower than in the control; serum PC-Ⅲ and HA levels were (106.4±17.9)μg/L and (122.3±15.6)μg/L, both significantly lower than in the control; the spleen thickness and LSM were (43.8±3.5)mm and (11.0±1.6)kPa, both much lower than in the control group. Conclusion The combination of a herbal medicine compound at base of entecavir antiviral therapy could improve liver function test normal and ameliorate liver fibrosis, and warrants further clinical investigation.

Key words: Liver cirrhosis, Hepatitis B, Entecavir, Fuzheng Jiedu Sanjie Decoction, Herbal medicine, Therapy

万贵香, 李忠廉, 赵亚博, 梁微微, 杜辉, 宁振海, 周媛, 万亮. 恩替卡韦联合扶正解毒散结方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(2): 234-237.

Wan Guixiang, Li Zhonglian, Zhao Yabo, et al.. Efficacy of entecavir and herbal compound combination in the treatment of patients with hepatitis B-induced liver cirrhosis[J]. Journal of Practical Hepatology, 2024, 27(2): 234-237.

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恩替卡韦联合扶正解毒散结方治疗乙型肝炎肝硬化患者疗效研究^*

Efficacy of entecavir and herbal compound combination in the treatment of patients with hepatitis B-induced liver cirrhosis

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