恩替卡韦联合扶正化瘀胶囊对慢性乙型肝炎肝纤维化的应用评价

Evaluation of entecavir combined with Fuzheng Huayu capsule applied in chronic hepatitis B liver fibrosis

目的评价分析恩替卡韦联合扶正化瘀胶囊对慢性乙型肝炎肝纤维化的应用效果。方法 86例慢性乙型肝炎肝纤维化患者,采用电脑双盲法分为研究组和对照组,每组43例。研究组患者采用恩替卡韦联合扶正化瘀胶囊治疗,对照组患者单纯采用恩替卡韦治疗。比较两组患者治疗前后的肝功能指标、肝脏僵硬程度(Stiffness)、肝脏影像变化、肝纤四项、乙型肝炎病毒脱氧核糖核酸(HBV-DNA)转阴情况。结果治疗后,两组患者的谷丙转氨酶、谷草转氨酶和总胆红素水平均低于治疗前,且研究组低于对照组,差异具有统计学意义(P<0.05);治疗后,两组患者的白蛋白水平高于治疗前,且研究组高于对照组,差异具有统计学意义(P<0.05)。治疗后,两组患者的肝脏僵硬程度、门静脉内径、脾厚度均显著低于治疗前,且研究组低于对照组,差异具有统计学意义(P<0.05)。治疗后,两组患者的透明质酸酶、Ⅲ型前胶原、Ⅳ型胶原、层粘连蛋白水平均低于治疗前,且研究组患者的透明质酸酶、Ⅲ型前胶原、Ⅳ型胶原、层粘连蛋白水平均低于对照组,差异具有统计学意义(P<0.05)。治疗前,研究组患者中HBV-DNA异常43例(100.00%),对照组患者中HBV-DNA异常43例(100.00%);治疗后,研究组患者HBV-DNA转阴35例(81.40%),对照组患者HBV-DNA转阴26例(60.47%),组间比较差异具有统计学意义(P<0.05)。结论采用恩替卡韦联合扶正化瘀胶囊对慢性乙型肝炎肝纤维化的治疗效果确切,推荐广泛应用。

Objective To evaluate and analyze the effect of entecavir combined with Fuzheng Huayu capsule applied in chronic hepatitis B liver fibrosis. Methods A total of 86 patients with chronic hepatitis B liver fibrosis were divided by computer double blind method into research group and control group, with 43 cases in each group. The research group was treated with entecavir combined with Fuzheng Huayu capsule, and the control group was treated with entecavir only. Comparison were made on liver function index, liver stiffness, liver imaging changes, four items of liver fibrosis and negative change of hepatitis B virus deoxyribonucleic acid (HBV-DNA) before and after treatment between the two groups. Results After treatment, both groups had lower alanine aminotransferase, aspartate aminotransferase and total bilirubin levels than those before treatment, and the research group was lower than the control group. Their difference was statistically significant (P<0.05). After treatment, both groups had higher albumin level than those before treatment, and the research group was higher than the control group. Their difference was statistically significant (P<0.05). After treatment, both groups had significantly lower liver stiffness, portal vein diameter, spleen thickness than those before treatment, and the research group was lower than the control group. Their difference was statistically significant (P<0.05). After treatment, both groups had lower hyaluronidase, type Ⅲ procollagen, type Ⅳ collagen, laminin levels than those before treatment, and the research group was lower than the control group. Their difference was statistically significant (P<0.05). Before treatment, the research group had 43 cases of HBV-DNA abnormality (100.00%), which was 43 cases (100.00%) in the control group. After treatment, the research group had 35 cases of HBV-DNA conversion (81.40%), which was 26 cases (60.47%) in the control group. Their difference was statistically significant (P<0.05). Conclusion Combination of entecavir and Fuzheng Huayu capsule shows affirmative effect in the treatment of chronic hepatitis B liver fibrosis, and it is worthy of wide application.