复方牛胎肝提取物联合恩替卡韦治疗慢性乙型肝炎疗效分析

Effect of combined therapy of compound embryonic bovine liver extract and entecavir in patients with chronic hepatitis B

目的探讨复方牛胎肝提取物片联合恩替卡韦片治疗慢性乙型肝炎患者的临床疗效。方法将48例慢性乙型肝炎患者随机分为治疗组24例,给予口服复方牛胎肝提取物片及恩替卡韦片;给予对照组24例口服恩替卡韦片,疗程均为48w。观察两组患者治疗前后肝功能、血清肝纤维化指标及肝穿刺活检组织病理学的变化情况。结果在治疗48w时,治疗组血清白蛋白水平为(41.0±2.9)g/L,显著高于对照组(36.2±2.2)g/L,P<0.01;治疗组血清透明质酸(HA)、层粘蛋白(LN)和IV型胶原(IV-C)水平分别为(158.0±70.3)ng/ml、(83.6±29.9)ng/ml和(90.3±41.2)ng/ml,显著低于对照组(170.6±71.1)ng/ml、(107.5±33.7)ng/ml和(113.5±52.4)ng/ml,P均<0.05;肝组织病理学检查显示治疗组患者肝脏炎症活动度及纤维化程度改善均优于对照组(P=0.041和P=0.044)。结论复方牛胎肝提取物片联合恩替卡韦片能显著改善慢性乙型肝炎患者肝脏炎症活动度及纤维化程度,促进白蛋白合成,疗效优于单用恩替卡韦治疗。

Objective To investigate the effect of combined therapy of compound embryonic bovine liver extract and entecavir in patients with chronic hepatitis B. Methods Forty-eight patients with chronic hepatitis B were randomly divided into treatment group （n=24） and control group （n=24）. Patients in treatment group were treated with compound embryonic bovine liver extract plus entecavir,and those in control group were treated with entecavir alone. The treatment lasted for 48 weeks and the liver function tests,serum hepatic fibrosis indexes and the histological activity index and fibrosis before and after treatment in the two groups were examined. Results At the end of 48 weeks of the treatment,serum albumin levels in patients in treatment group （41.0±2.9 g/L）were significantly higher than that in the controls（36.2±2.2 ） g/L,P〈0.01;Serum hyaluronic acids （158.0±70.3）ng/ml, laminin （83.6±29.9） ng/mland collagen type IV （90.3±41.2） ng/mlin the treatment group were significantly lower than those in the controls （170.6±71.1） ng/ml,（107.5±33.7） ng/ml and （113.5±52.4） ng/ml,respectively,P〈0.05）;Histopathological examinations of the liver biopsies showed that the grades and stages of the liver injuries in treatment group were decreased significantly as compared with in control group（P〈0.05）. Conclusions Combined therapy of compound embryonic bovine liver extract and entecavir are better than entecavir alone in inhibiting liver inflammation and fibrosis in patients with chronic hepatitis B.