复方鳖甲软肝片联合恩替卡韦治疗慢性乙型肝炎纤维化的临床效果

Clinical Efficacy of Fufang Biejia Ruangan Tablet Combined with Entecavir in Treating Chronic Hepatitis B Patients with Liver Fibrosis

目的:观察复方鳖甲软肝片联合恩替卡韦治疗慢性乙型肝炎(CHB)纤维化的效果及对患者血清单胺氧化酶(MAO)和转化生长因子-β1(TGF-β1)水平的影响。方法:选取2016年2月-2017年5月笔者所在医院收治CHB肝纤维化患者102例,按数字表法随机分为治疗组和对照组,每组51例。对照组给予恩替卡韦分散片,1片/次,1次/d。治疗组在对照组基础上口服复方鳖甲软肝片,4片/次,3次/d。两组连续治疗6个月。比较两组肝功能、肝纤维化指标及临床疗效。检测两组血清MAO和TGF-β1水平。结果:治疗后,治疗组肝功能指标AST(61.88±6.75)U/L、ALT(81.78±8.75)U/L、GGT(67.83±7.69)U/L和HA(101.25±11.96)mg/L、PCⅢ(96.17±10.35)ng/ml、Ⅳ-C(52.41±6.11)ng/ml及LN(104.85±11.89)mg/L,显著低于对照组(P<0.01)。治疗组患者的总有效率为90.20%,显著高于对照组(72.55%),差异有统计学意义(χ~2=4.140,P=0.042)。治疗后,治疗组血清MAO(15.71±1.91)U/L和TGF-β1(0.95±0.03)pg/L,显著低于对照组(P<0.01)。结论:复方鳖甲软肝片联合恩替卡韦治疗CHB纤维化可明显改善患者肝功能和肝纤维化,提高临床疗效,抑制血清MAO和TGF-β1水平可能是其治疗途径之一。

Objective： To observe efficacy of Fufang Biejia Ruangan Tablet combined with Entecavir in the treatment of chronic hepatitis B（CHB） patients with liver fibrosis, and the effect on serum levels of monoamine oxidase（MAO） and transforming growth factor beta I（TGF-β1）.Method： One hundred two cases CHB patients with hepatic fibrosis were randomly divided into the control group（51 cases） and the treatment group（51 cases） referring to the random number table method.The control group was given with Entecavir Dispersible Tablets（1 tablet/time and qd）.On basis of the control group, the treatment group was given with Fufang Biejia Ruangan Tablet（4 tablets/time and tid）.Both groups were treated for 6 months.Liver function, liver fibrosis indexes, and efficacy were compared in two groups.Serum levels of MAO and TGF-β1 were detected in two groups.Result： After treatment, liver function indexes aspartate aminotransferase（AST） was （61.88 ± 6.75）U/L, alanine aminotransferase（ALT） was （81.78± 8.75）U/L, γ-glutamic acyhransferase（GGT） was （67.83 ± 7.69）U/L and liver fibrosis indexes hepatic fibrosis markers hyaluronate（HA） was （101.25 ± 11.96）mg/L, procollagen Ⅲ（PC Ⅲ） was （96.17 ± 10.35）ng/ml, collagen Ⅳ（Ⅳ-C） was （52.41 ± 6.11）ng/ml and laminin（LN） was （104.85 ± 11.89）mg/L, they were obviously lower than those of control group（P〈0.01）.Total effective rate of the treatment group was 90.20%, which was remarkably higher than control group as 72.55%（χ^2=4.140, P=0.042）.After treatment, serum levels of MAO was （15.71 ± 1.91）U/L and TGF-β was （0.95 ± 0.03）pg/L of treatment group, they were obviously lower than the control group（P〈0.01）.Conclusion： Fufang Biejia Ruangan Tablet combined with Entecavir in the treatment of CHB with liver fibrosis can obviously improve liver function and hepatic fibrosis, and inhibition of serum levels of MAO and TGF-β1, may be one of treatment ways.