双环醇联合恩替卡韦治疗乙型肝炎后肝硬化疗效观察

Effects of combination of Bicyclo I Tablets and Enticavir on treatment of liver cirrhosis with chronic hepatitis B

目的:评价恩替卡韦联合双环醇治疗乙型肝炎后肝硬化的疗效。方法:50例活动性乙型肝炎后肝硬化患者随机分为联合治疗组及对照组,每组25例。对照组在护肝、对症等常规治疗基础上服用恩替卡韦0.5 mg/d,联合治疗组在对照组基础上口服双环醇50 mg,3次/d,疗程48周。结果:48周后2组肝功能均有不同程度改善,联合治疗组较对照组改变更显著[ALT(50±13)U/L vs(64±14)U/L、TBil:(31±16)μmol/L vs(43±20)μmol/L、ALB:(37.5±3.3)g/L vs(34.5±3.5)g/L,均差异有统计学意义(P<0.05);联合治疗组与对照组的Child-Pugh评分分别由治疗前(9.7±1.4)分和(9.6±1.3)分降至治疗后(6.2±1.5)分和(7.1±1.4)分,同组治疗前后比较,差异有统计学意义(P<0.05),联合治疗组肝功能Child-Pugh评分改善更明显(P<0.05);同期HBV DNA转阴率两组比较差异无统计学意义(P>0.05);2组患者门静脉宽度及脾脏厚度均有不同程度缩小,联合治疗组的缩小更明显[(1.18±0.29)cm vs(1.36±0.30)cm;(4.14±0.97)cm vs(4.76±1.05)cm,差异有统计学意义(P<0.05)]。结论:双环醇联合恩替卡韦治疗乙型肝炎后肝硬化能有效抑制乙型肝炎病毒复制,改善肝功能。

Objective To observe effects of combination of Bicyclo I Tablets and enticavir on liver cirrhosis with chronic hepatitis B. Method 50 cases with liver cirrhosis with chronic hepatitis B were randomly divided into control group and treatment group,each of 25 patients. Both groups were administered with routine therapy and enticavir. Bicyclo I Tablets were given extra to the treatment group（ P〈0. 05）. The levels of ALT,Tbil,HBV DNA were detected in the patients of both groups at 24 weeks and 48 weeks,respectively. The diameter of Dortal vein and the thickness of spleen were detected in both groups at 48 weeks. Results The liver function of the treatment group was more remarkably ameliorated than that of the control group（ P〈0. 05）. The level of HBV DNA was decreased in both groups,but with no statistical significance. The diameter of Dortal vein and the thickness of spleen were reduced significantly in both groups after 48 weeks,and the data of the treatment group was reduced more significantly than that of the control group（ P〈0. 05）. Conclusion The combined therapy of Bicyclo I Tablets and enticavir on liver cirrhosis with chronic hepatitis B can inhibit HBV replication and improve liver function.