恩替卡韦联合安络化纤丸治疗乙型肝炎肝硬化32例疗效分析

Therapeutic efficacy of entecavir and Anluohuaxianwan on 32 patients with hepatitis B-related cirrhosis

目的观察恩替卡韦(ETV)联合安络化纤丸治疗乙型肝炎肝硬化的疗效。方法将61例乙型肝炎肝硬化患者随机分为2组,治疗组32例,对照组29例。治疗组采用ETV0.5mg/d,联合安络化纤丸6g/d,2次/d,治疗12个月;对照组采用ETV0.5mg/d,治疗12个月。结果治疗12个月时治疗组与对照组患者的血清HBVDNA转阴率分别为96.8%(31/32)和96.5%(28/29)。治疗组13例血清HBeAg阳性患者中,4例转阴;对照组9例HBeAg阳性患者中,3例转阴。Child-Pugh评分分别由治疗前的(8.9±3.7)分和(9.0±1.8)分降至治疗后的(5.0±0.1)分和(7.4±1.2)分(P<0.01)。治疗后治疗组门静脉内径缩小和脾厚度复常较对照组明显(P<0.05),治疗组血清肝纤维化指标下降更显著(P<0.01)。结论 ETV联合安络化纤丸治疗乙型肝炎肝硬化有一定的协同作用。

Objective To evaluate the efficacy of entecavir （ETV） combined with A nluohuaxianwan in treatment of patients with hepatitis B-related cirrhosis. Methods Totally 61 patients with hepatitis B-related cirrhosis were randomly assigned to a treatment group （n=32） and a control group （n=29）. The treatment group received ETV 0.5 mg daily combined with Anluohuaxianwan 6 g daily,twice per day, for 12 months, while the control group received ETV 0.5 mg daily for 12 months. Results After 12 months of treatment, 31 patients （96.8%） in the treatment group and 28 （96.5%） in the control group achieved undeteetable HBV DNA. HBeAg loss was observed in 4 of 13 HBeAg-positive patients in the treatment group and in 3 of 9 HBeAg-positive patients in the control group, respectively. Before treatment, Child-Pugh scores were 8.9±3.7 in the treatment group and 9.0±1.8 in the control group, respectively, and decreased significantly after treatment （5.0±0.1, 7.4±1.2）. After treatment, portal vein diameter and spleen thickness of the patients in the treatment group reduced more significantly than those of the patients in the control group （P〈 0.05）, and serum parameters of liver fibrosis decreased significantly in the treatment group compared with the control group （P〈0.01）. Conclusion ETV combined with A nluohuaxianwan achieves efficacy on the patients with hepatitis B-related cirrhosis.