鳖甲软肝片联合恩替卡韦治疗乙肝肝纤维化的临床研究

Clinical study on treatment of hepatitis B liver fibrosis with Biejia Ruangan tablets combined with entecavir

目的探讨鳖甲软肝片联合恩替卡韦治疗乙肝肝纤维化的临床应用效果。方法162例于2016年4月至2018年10月期间就诊于沈阳市第六人民医院乙肝纤维化患者随机分成对照组和治疗组,每组81例。对照组口服恩替卡韦片治疗,治疗组在对照组基础上加服鳖甲软肝片治疗,6个月为1个疗程,共2个疗程。观察比较两组肝纤维化FIB-4指标、肝脏瞬时弹性成像检测值(LSM)、血浆D-二聚体、肝门静脉主干直径(PD)与门脉血流均速(PVa)比值及临床疗效变化。结果与对照组比较,治疗组中血浆D-二聚体及PD/PVa比值在治疗6个月及12个月后均有显著改善,且治疗12个月后显著优于治疗6个月后(P<0.05),而FIB-4指标、LSM值只在治疗12个月后存在明显改善(P<0.05);同组内与治疗前比较(0月),除对照组治疗治疗6个月、12个月后FIB-4与LSM值,及治疗6个月后对照组血浆D-二聚体水平差异无统计学意义外,其余各指标在同组间均较其余时期差异均有统计学意义(P<0.05)。结论鳖甲软肝片联合恩替卡韦可通过抗肝纤维化、改善门静脉血流动力学达到降低肝硬化高危因素、延缓疾病进展的目的。

Objective To investigate the clinical application of Biejia Ruangan tablets combined with entecavir in the treatment of hepatitis B liver fibrosis.Methods A total of 162 patients with hepatitis B fibrosis were randomly divided into control group and treatment group,with 81 cases in each group.The control group was treated with entecavir tablets,the treatment group was treated with Biejia Ruangan tablets on the basis of the control group,and6 months for 1 course of treatment,a total of 2 courses.Observed and compared the two groups of liver fibrosis FIB-4 index,liver transient imaging measurement(LSM),plasma D-dimer,hepatic portal vein diameter(PD)and portal blood flow velocity(PVa)ratio and clinical efficacy changes.Results Compared with the control group,the plasma D-dimer and PD/PVa ratios in the treatment group were significantly improved after 6 months and 12 months of treatment,and significantly improved after 12 months of treatment than 6 months after treatment(P<0.05),and FIB-4 index and LSM value only showed significant improvement after 12 months of treatment(P<0.05);Compared with pre-treatment(0 month)in the same group,except for the control group for 6 months.There was no significant difference in FIB-4 and LSM values after 12 months,and plasma D-dimer levels in the control group after6 months of treatment.The other indicators were statistically different between the same groups(P<0.05).Conclusion Biejia Ruangan tablets combined with entecavir can reduce the risk factors of liver cirrhosis and delay the progression of disease by anti-liver fibrosis and improving portal hemodynamics.