益肾疏肝活络方合恩替卡韦治疗肾虚血瘀型慢性乙肝肝纤维化的研究

Study on Yishen Shugan Tongluo Recipe combined with entecavir in treatment of chronic hepatitis B hepatic fibrosis of kidney deficiency and blood stasis type

目的观察益肾疏肝活络方联合恩替卡韦治疗肾虚血瘀型慢性乙肝肝纤维化的临床疗效。方法将120例慢性乙肝肝纤维化患者随机分为2组,治疗组60例给予益肾疏肝活络方联合恩替卡韦治疗,对照组60例给予合恩替卡韦,疗程均为4周。2组分别于治疗前及治疗24,48周后检测HBV DNA转阴率、肝功能、血清肝纤维化指标、血常规、肾功能、尿常规,并于治疗前及48周结束后行肝脏穿刺病理活检术,统计肝硬化的发生率。结果 2组治疗后肝纤维化分期及炎症活动度、肝功能和肝纤维化指标均明显改善,且治疗组改善情况明显优于对照组(P均<0.05);治疗后治疗组HBV DNA转阴率及总有效率均明显高于对照组(P均<0.05),肝硬化发生率明显低于对照组(P<0.05)。结论益肾疏肝活络方联合恩替卡韦可以明显延缓和/或逆转肾虚血瘀型慢性乙肝肝纤维化的进展。

Objective It is to observe the clinical effect of Yishen Shugan Tongluo Recipe（ YSTR） combined with entecavir in treatment of chronic hepatitis B hepatic fibrosis of kidney deficiency and blood stasis type. Methods 120 patients with chronic hepatitis B hepatic fibrosis were divided into two groups,60 cases in the treatment group were treated with YSTR combined with entecavir,60 cases in the control group were treated with entecavir only,the course of treatment was 4 weeks. Before treatment and after 24 weeks and 48 weeks of treatment,the HBV DNA negative rate,liver function（ ALT,AST）,serum liver fibrosis indexes（ HA,Ⅳ- C,PCⅢ,LN）,blood routine,renal function,urine routine were detected. Before treatment and after treatment for 48 week,the liver biopsy,the incidences of cirrhosis of the liver were observed. Results The hepatic fibrosis staging and inflammation activity,liver function and the index of hepatic fibrosis and cirrhosis of the liver were significantly improved（ all P〈0. 05）,and that of the treatment group were improved significantly better than the control group（ all P〈0. 05）. The HBV DNA negative rate and the total effective rate of treatment group were higher than those of control group（all P〈0. 05）,and the rate of liver cirrhosis of treatment group was lower than that of control group（P〈0. 05）. Conclusion YSTR combined with entecavir can obviously delay and / or reverse the progress of chronic hepatitis B liver fibrosis reversal of kidney deficiency and blood stasis type.