恩替卡韦联合柔肝散结汤治疗慢性乙型病毒性肝炎肝硬化疗效观察

Clinical observation of combination of entecavir and Rougan Sanjie decoction on the treatment of chronic viral hepatitis B cirrhosis

目的观察恩替卡韦联合柔肝散结汤治疗慢性乙型病毒性肝炎(以下简称乙肝)肝硬化的临床疗效。方法将乙肝肝硬化60例随机分为2组,对照组30例予恩替卡韦0.5mg,每日1次口服,治疗组30例在对照组基础上予柔肝散结汤,日1剂,水煎服。2组均以6个月为1个疗程。观察2组治疗前后肝功能(Child-Pugh)积分、血清生化学指标[包括丙氨酸氨基转移酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBiL)]及乙肝病毒脱氧核糖核酸(HBV-DNA)、血清肝纤维化指标[血清透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PC-Ⅲ)、Ⅳ型胶原(Ⅳ-C)]。结果治疗组血清肝纤维化指标(HA,PC-Ⅲ)降低明显,与对照组比较差异有统计学意义(P<0.05);TBiL复常率治疗组优于对照组(P<0.05)。2组治疗后Child-Pugh积分均减少,HBV-DNA水平下降,组间比较差异无统计学意义(P>0.05)。结论恩替卡韦联合柔肝散结汤治疗慢性乙肝肝硬化能协同改善肝功能及预后。

Objective To observe the effect of combination of entecavir and Rougan Sanjie decoction on the treatment of chronic viral hepatitis B cirrhosis.Methods 60 cases of chronic viral hepatitis B cirrhosis were randomly divided into two groups. 30 cases in control group were treated by entecavir, 0.5mg, once a day. Patients in treatment group were treated by combination of Rougan Sanjie decoction and entecavir. Child-Pugh score, serological biochemical markers, HBV-DNA and serological hepatic fibrosis indexes were measured before and after treatment in two groups. Results Six months after treatment, HA and PC-Ⅲ in treatment group were obviously decreased （P0.05）. Normalization of TBil in treatment group was superior to that in control group （P0.05）.Child-Pugh score and HBV-DNA in two groups was decreased after treatment （P0.05）.Conclusion Combination of entecavir and Rougan Sanjie decoction can cooperatively improve liver function and prognosis on the treatment of chronic hepatitis B cirrhosis.