恩替卡韦联合扶正化瘀胶囊治疗HBeAg阳性失代偿期肝硬化患者的疗效分析

Analysis on the therapeutic effect of nucleoside antiviral drugs combined with fuzheng huayu capsule for treating HBe Ag-positive HBV infection decompensated cirrhosis patients

目的:探讨恩替卡韦联合扶正化瘀胶囊治疗HBe Ag阳性失代偿期肝硬化患者的临床疗效。方法:选取HBe Ag阳性失代偿期肝硬化患者138例,随机分为3组,每组46例。A组给予恩替卡韦治疗;B组给予恩替卡韦+复方鳖甲软肝片治疗;C组给予恩替卡韦+扶正化瘀胶囊治疗。观察3组患者治疗前后肝功能、肝纤维化指标变化及HBV DNA载量、HBV DNA转阴率及HBe Ag转阴率。结果:3组患者治疗后肝功能、肝纤维化指标较治疗前好转;B、C两组患者治疗后ALT、AST、TBil、HA、LN、PCⅢ、CⅣ著低于A组治疗后,ALB高于A组治疗后;B、C两组患者门静脉内径、脾静脉内径、脾脏厚度较A组明显减少;B、C两组患者治疗后HBV DNA转阴率、HBe Ag转阴率显著高于A组治疗后;HBV DNA载量低于A组治疗后;差异均有统计学意义(P<0.05);B、C两组上述指标比较,差异无统计学意义(P>0.05)。结论:恩替卡韦联合扶正化瘀胶囊治疗HBe Ag阳性失代偿期肝硬化患者疗效确切,可以明显改善肝功能,有效抑制HBV复制。

Objective： To explore the therapeutic effect of nucleoside antiviral drugs combined with fuzheng huayu capsule for treating HBe Ag-positive HBV infection decompensated cirrhosis patients. Methods： One hundred and thirty-eight decompensated cirrhotic patients were selected to meet the requirements,Randomly divided into 3 groups,each group of 46 cases. Group A was treated with entecavir; group B was given entecavir and fufang biejia ruangan tablet; group C was given entecavir and fuzheng huayu capsule. Liver function,liver fibrosis markers,HBV DNA level,negative conversion rate of HBV DNA and HBe Ag were observed. Results： 3 groups of patients after treatment,liver function,liver fibrosis indicators improved compared with before treatment. After treatment,Alanine aminotransferase,aspartate aminotransferase,total bilirubin,hyaluronic acid,laminin,procollagen typeⅢ and type IV collagen in B and C group were lower than those in group A; Albumin was higher than group A. The diameter of portal vein,diameter of splenic vein and pleen thickness were significantly less than after treatment in group A. After treatment,HBV DNA negative rate,HBe Ag negative rate of B,C two groups were significantly higher than the A group after treatment; HBV DNA level significantly lower than the A group after treatment. The difference was statistically significant（ P〈0. 05）. The above indicators B,C two groups were not statistically significant（ P〉0. 05）. Conclusion： Nucleoside antiviral drugs entecavir combined with fuzheng huayu capsule have an exactly clinical effect in treating decompensated hepatitis B cirrhosis,can effectively improve the liver function,and can effectively inhibit HBV replication.