扶正化瘀胶囊联合恩替卡韦治疗对慢性乙型肝炎患者肝组织病理的影响

Effect of Fuzheng Huayu capsule combined with entecavir on hepatic tissue pathology in patients with chronic hepatitis B

目的:观察扶正化瘀胶囊联合恩替卡韦联合治疗对慢性乙型肝炎患者肝组织病理的影响。方法:选取136例慢性乙型肝炎患者,随机分为治疗组(扶正化瘀胶囊联合恩替卡韦)和对照组(单用恩替卡韦)各68例。观察两组患者治疗前、治疗12周、治疗24周、治疗48周时的肝功能、HBV DNA、肝纤维化指标及肝脏组织病理学变化。通过治疗前后肝活检观察肝组织病理炎症分级及纤维化分期以及血清肝纤维化指标的变化来评估扶正化痰胶囊的疗效。结果:两组患者治疗至48周时在HBV DNA的阴转率和ALT的复常率比较无明显的差异(P>0.05)。但两组患者在肝纤维化指标及肝脏组织病理学的改善上有明显的差异(P<0.05),两组患者在治疗的过程中未见明显的不良反应。结论:扶正化瘀胶囊联合恩替卡韦治疗慢性乙型肝炎患者具有减轻肝组织炎症和纤维化的作用。

Objective： To observe the effect of Fuzheng Huayu capsule combined with entecavir on hepatic tissue pathology in patients with chronic hepatitis B. Methods： One hundred and thirty six cases of chronic hepatitis B were randomly divided into treatment group （ Fuzhenghuayu capsules combined entecavir） and control group（entecavir） for each 68 cases. Liver function, HBV-DNA, liver fibrosis and liver histopatbologieal changes were tested at before treatment, 12 weeks, 24 weeks, 48 weeks in both groups. Before and after treatment by measuring liver biopsy samples of liver tissue pathological inflammation grade and fibrosis stage and regular serum fibrosis index range to eval- uate the effect of Fuzheng Huayu capsule. Results： Two groups of patients showed no significant difference in the negative rate of HBV-DNA and ALT normalization rate after treatment of 48 weeks （ P 〉 0.05 ）. But there were significant differences improvement in liver fibrosis and liv- er histopatbology between two groups（P 〈0.05）. At the same time , no significant adverse reactions occurred in the treatment process be- tween the two groups. Conclusion： Fuzhenghuayu capsule combined with entecavir played an important part in reducing liver inflammation and necrosis of tissue and reversing liver fibrosis obvious effect.