恩替卡韦联合复方丹参片治疗慢性乙型肝炎肝纤维化指标及病理观察

Observation of serum index and pathology in hepatic fibrosis of chronic hepatitis B treated with Entecavir combined with Fufang Danshen tablets

目的:观察恩替卡韦联合复方丹参片治疗慢性乙型肝炎对肝纤维化指标和肝组织病理的影响。方法:选取慢性乙型肝炎患者85例,随机分为两组:对照组患者41例,采用恩替卡韦0.5mg,1次/d,口服;治疗组患者44例,采用恩替卡韦0.5mg,1次/d,口服,同时加用复方丹参片,每次3片,3次/d。疗程均为48周。治疗前后检测患者血清肝纤维化指标、肝生化学指标和HBV DNA。部分病例(治疗组33例、对照组27例)于基本疗程前后行肝穿刺活体组织病理学检查,作组织学炎症活动度和纤维化程度评分。观察治疗后患者的上述指标变化,并作比较研究。结果:两组患者治疗后肝生化学指标及HBV DNA水平较治疗前改善明显(P<0.05);与对照组比较,治疗组肝纤维化指标明显下降(P<0.05),患者的肝组织学评估结果有明显改善(P<0.05)。结论:恩替卡韦联合复方丹参片治疗慢性乙型肝炎肝纤维化临床疗效较单独使用恩替卡韦更好。

Objective：To observe effects of Entecavir combined with Fufang Danshen tablets on serum index and liver patholo-gy in hepatic fibrosis of chronic hepatitis B. Methods：A total of 85 patients with chronic hepatitis B were randomly divided into two groups： control group （41 cases） orally took Entecavir 0. 5mg at 1 time/ day; and treatment group （44 cases） orally took Entecavir 0. 5mg at 1 time/ day and Fufang Danshen tablets at 3 tablets one time and 3 times/ day, and all patients were treated for 48 weeks. Be-fore and after the treatment, the related hepatic fibrosis serum index, biochemical index of liver and HBV-DNA were measured. Some cases （33 cases in treatment group and 27 cases in control group） were given the biopsy pathological examination through liver biopsy before and after the treatment for the inflammation activity and fibrosis degree scores, and the changes of these indices were observed and compared. Results： The levels of hepatic biochemistry index and HBV DNA of the two groups after the treatment were all signifi-cantly lower than those before the treatment （P〈0. 05）; compared with those of control group, the level of serum hepatic fibrosis index of treatment group was significantly lower （P〈0. 05） and liver histopathological changes were significantly improved after the treatment （P〈0. 05）. Conclusions： Fufang Danshen tablets combined with Entecavir has a better clinical therapeutic effect on hepatic fibrosis of chronic hepatitis B.