中西医结合治疗肝纤维化临床观察

Clinical observation on treatment of liver fibrosis with combine traditional Chinese and western medicine

目的:观察恩替卡韦片联合自拟鳖甲化瘀软肝中药配方颗粒剂治疗肝纤维化的临床疗效。方法:120例慢性乙型肝炎肝纤维化患者采用随机数字表法分为3组。中药组给予鳖甲软肝化瘀颗粒剂口服;中西药结合组除给予恩替卡韦片0.5mg/次、1次/d口服外,同时口服上方;西药治疗组给予恩替卡韦片口服,方案同上。30d为1个疗程,6个疗程后评价患者肝功能、肝纤维化指标及肝脏血管超声等变化。结果:治疗后与西药组比较,中西药组及中药组患者血清中层黏蛋白(LN)、Ⅲ型前胶原(PC-Ⅲ)、透明质酸(HA)、总胆红素(TBIL)含量较低(P<0.05),凝血凝原活动度(PTA)、白蛋白(ALB)较高(P<0.05),脾脏厚度及肝固有动脉血流速度与门静脉血流速度比值(A/P)均较低(P<0.05);3组总有效率分别为87.5%、72.5%、70.0%,差异有统计学意义(P<0.05)。结论:鳖甲化瘀软肝中药配方颗粒剂联合恩替卡韦片口服能改善肝脏纤维化生化指标,减轻脾脏肿大及A/P比值,改善肝脏合成及代谢等功能。

Objective： To observe the clinical effect of treating hepatic fibrosis with combined entecavir tablets and Biejia Huayu Ruangan Granules. Methods： 120 patients were randomly divided into 3 groups according to table of random number method. Patients in Chinese medicine group were treated with Biejia Ruangan Huayu Granules, patients in combine traditional Chinese and western medicine group were treated with entecavir tablets （0.5mg/time, 1 time/day） and Beijia Huayu Ruangan Granules, and patients in western medicine group were treated with entecavir tablets. All the patients were treated for 6 periods of treatment and 30 days for a period of treatment. After the treatment, the liver funtion, hepatic fibrosis index, the liver vascular ultrasound were evaluated. Results： Compared with combine traditional, Chinese and western medicine group, the differences of LN, PC-IH, HA, PTA, TBIL, ALB, spleen thickness and ratio of A/P of after treatment were changed significantly in Chinese medicine group and western medicine group （P〈0.05）. Total effective rate of the three groups was 87.5%, 72.5% and 70.0% respectively, and the differences were statistically significant （P〈0.05）. Conclusion： Biejia Huayu Ruangan Granules combined with entecavir tablets could improve the biochemical indicators of hepatic fibrosis, reduce splenomegaly and ratio of A/P, and promote the synthesis and metabolism functions of hepatic.