地五养肝方治疗HBeAg阴性慢性乙型肝炎的疗效及肝脏瞬时弹性变化的意义

The effect of Diwu Yangganfang in treatment for HBeAg-negative chronic hepatitis B and its influence on liver stiffness measurement

目的探讨地五养肝方治疗HBeAg阴性慢性乙型肝炎(CHB)的疗效及肝脏瞬时弹性值(LSM)变化的意义。方法将103例HBeAg阴性CHB患者随机分为对照组和治疗组,对照组予以恩替卡韦治疗,治疗组在对照组治疗基础上,加用地五养肝方,两组共治疗48周。观察两组患者治疗前后血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、透明质酸(HA)及HBVDNA水平,并运用肝脏瞬时弹性超声成像(fibroscan,FS)测量治疗前后的LSM值。结果治疗48周后,治疗组患者HA及ALT较对照组明显降低(P<0.05),两组在HBVDNA转阴方面比较差异亦有统计学意义(P<0.05)。两组患者LSM较治疗前显著下降,治疗组明显低于对照组(P<0.01)。结论地五养肝方治疗HBeAg阴性CHB疗效显著;LSM下降是治疗有效的表现之一,LSM可作为CHB患者疗效评估及随访观察的新指标。

Objective To investigate the effect of Diwu Yangganfang in treatment for HBeAg-negative chronic hepatitis B and its influence on liver stiffness measurement. Methods 103 cases of patients with HBeAg-negative CHB were randomly divided into2 groups,the control group was only given entecavir 0. 5mg/d,the treatment group was added with Diwu Yangganfang on the basis of treatment with entecavir. The treatment course was 48 weeks. The relative detection were performed in serum parameters such as ALT,HA and HBV DNA level. Simultaneously,the LSM of all patients were recorded by fibroscan（FS） before and after treatment. Results At week 48 treatment,compared with the control group,serum ALT,HA and the average LSM of treatment group was significantly lower（P〈0. 05）. The negative conversation rate of HBV DNA was significantly higher in the treatment group（P〈0. 05）. Conclusion Diwu Yangganfang combined with entecavir has a significant effect on HBeAg-negative CHB. Decline in LSM may be a useful predictor of efficacious,and LSM may be an important parameter for evaluation of efficacy and follow-up of patients with HBeAg-negative CHB.