叶下珠胶囊联合多烯磷脂酰胆碱治疗慢性乙型肝炎的临床研究

Clinical study on Yexiazhu Capsules combined with polyenoic phosphatidylcholine in treatment of chronic hepatitis B

目的探讨采用叶下珠胶囊联合多烯磷脂酰胆碱治疗慢性乙型肝炎的临床效果。方法选取重庆三峡中心医院2015年4月—2017年4月收治的慢性乙型肝炎患者129例,随机分成对照组(64例)和治疗组(65例)。对照组静脉滴注多烯磷脂酰胆碱注射液,15 m L加入5%葡萄糖注射液250 m L,1次/d;治疗组患者在对照组基础上口服叶下珠胶囊,2粒/次,3次/d。两组患者均连续治疗4周。观察两组患者临床疗效,比较治疗前后两组患者肝功能指标、肝纤维化指标和乙肝病毒标志物转阴率。结果治疗后,对照组临床总有效率为76.56%,显著低于治疗组的92.31%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者的肝功能指标丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)和总胆红素(TBIL)均显著降低(P<0.05),且治疗组患者肝功能指标水平明显低于对照组(P<0.05)。治疗后,两组患者的透明质酸(HA)、IV胶原蛋白(IV-C)和Ⅲ型前胶原肽(PCⅢ)均显著降低(P<0.05),且治疗组患者肝纤维化指标低于对照组(P<0.05)。治疗后,治疗组患者HBV-DNA和乙肝e抗原(HBe Ag)转阴率均显著高于对照组,两组比较差异具有统计学意义(P<0.05)。结论叶下珠胶囊联合多烯磷脂酰胆碱治疗慢性乙型肝炎疗效显著,安全性较高,具有一定的临床推广应用价值。

Objective To explore the clinical effect of Yexiazhu Capsules combined with polyenoic phosphatidylcholine in treatment of chronic hepatitis B. Methods Patients（129 cases） with chronic hepatitis B in Chongqing Three Gorges Central Hospital from April 2015 to April 2017 were randomly divided into control（64 cases） and treatment（65 cases） groups. Patients in the control group were iv administered with Polyene Phosphatidylcholine Injection, 15 m L added into 5% glucose solution 250 m L, once daily. Patients in the treatment group were po administered with Yexiazhu Capsules on the basis of the control group, 2 grains/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the liver function indexes, liver fibrosis indexes, HBV marker negative rate in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 76.56%, which was significantly lower than 92.31% in the treatment group, and there were differences between two groups（P〈0.05）. After treatment, the ALT, AST and TBIL levels in two groups were significantly decreased（P〈0.05）, and the liver function indexes levels in the treatment group were significantly lower than those in the control group（P〈0.05）. After treatment, the HA, IV-C and PC levels in two groups were Ⅲ significantly decreased（P〈0.05）, and the liver fibrosis indexes levels in the treatment group were significantly lower than those in the control group（P〈0.05）. After treatment, the negative rate of HBV-DNA and HBe Ag in the treatment group was significantly higher than that in the control group, with significant difference between two groups（P〈0.05）. Conclusion Yexiazhu Capsules combined with polyenoic phosphatidylcholine has significant effect in treatment of chronic hepatitis B with high safety, which has a certain clinical application value.