丹鸡活血汤联合恩替卡韦片治疗慢性乙型肝炎肝硬化的疗效及对患者血清炎症因子和肝功能的影响

Effect of Danji Huoxue decoction combined with entecavir tablet on chronic hepatitis B cirrhosis and its effect on serum inflammatory factors and bilirubin

目的观察丹鸡活血汤联合恩替卡韦片治疗慢性乙型肝炎(以下简称乙肝)肝硬化的疗效及对患者血清炎症因子和肝功能的影响。方法将126例乙肝肝硬化患者按照随机数字表法分为2组。对照组63例予恩替卡韦片口服治疗;治疗组63例在对照组治疗基础上加用丹鸡活血汤治疗。2组均治疗6个月。比较2组临床疗效;比较2组治疗前后肝功能指标天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、碱性磷酸酶(ALP)、γ-谷氨酰转移酶(γ-GT)、总胆红素(TBi L)、直接胆红素(DBi L)、间接胆红素(IBi L)变化;比较2组治疗前后肝纤维化血清标志物透明质酸(HA)、Ⅲ型前胶原氨基末端肽(PCⅢ)、层粘连蛋白(LN)及Ⅳ型胶原变化;比较2组治疗前后血清炎症因子肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-6、IL-8、IL-10及γ干扰素(INF-γ)变化。结果治疗组总有效率92.06%,对照组总有效率66.67%,治疗组临床疗效优于对照组(P<0.05)。2组治疗后AST、ALT、ALP、γ-GT、TBi L、DBi L及IBi L均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后HA、LN、PCⅢ及Ⅳ型胶原均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后血清TNF-α、IL-6及IL-8均较本组治疗前降低(P<0.05),血清IL-10、INF-γ均较本组治疗前升高(P<0.05);治疗后治疗组血清TNF-α、IL-6及IL-8均低于对照组(P<0.05),血清IL-10、INF-γ均高于对照组(P<0.05)。结论丹鸡活血汤联合恩替卡韦片治疗乙肝肝硬化临床疗效显著,能有效改善患者肝功能及炎症因子水平,降低肝纤维化血清标志物水平,且临床安全性高。

Objective To observe the effects of Danji Huoxue decoction combined with entecavir tablet on chronic hepatitis B cirrhosis and its effect on serum inflammatory factors and bilirubin. Methods 126 patients with hepatitis B cirrhosis were divided into two groups according to the random number table method. 63 patients in control group were treated by entecavir tablets orally. 63 patients in treatment group were treated by Danji Huoxue decoction on the basis of the control group. Both groups were treated for 6 months. The clinical effects of the two groups were compared, and the liver function indexes [aspartate aminotransferase（AST）, alanine aminotransferase （ALT）, alkaline phosphatase （ALP）, gamma-glutamyl transferase （γ-GT） and total bilirubin （TBiL）, direct bilirubin （DBiL）, indirect bilirubin （IBiL） were compared before and after treatment. The serum hyaluronic acid A（HA）of liver fiosic,procollagen amine terminal peptideⅢ（PCⅢ）,and laminin（LN）and collagen Ⅳ before and after treatment were compared.The changes of serum inflammatory factors （ tumor necrosis factor-α （TNF-α）, interleukin-6 （IL-6）, IL-8, IL-10 and IFN-γ） were compared between the two groups before and after treatment. Results The total effective rate was 92.06 % in the treatment group and 66.67 % in the control group. The clinical effect of the treatment group was better than that of the control group （ P 〈0.05）. After treatment,the AST、ALT、ALP、γ-GT、TBiL、DBiL and IBiL of the two groups all decreased（ P 〈0.05）,and the treatment group decreased more obvionsly（ P 〈0.05）.After treatment the HA、LN、PCⅢ and collagen Ⅳ of the two groups all decreased（ P 〈0.05）,and the treatment group decreased more obviously（ P 〈0.05）. The levels of serum TNF-α, IL-6 and IL-8 in the two groups were lower than those in the group before treatment （ P 〈0.05）, and serum IL-10 and INF-γ were higher than those in the group before treatment （ P 〈0.05）. The serum TNF-α, IL-6 and IL-8 were lower in the treatment group than in the control group （ P 〈0.05）, the serum IL-10 and INF-γ were higher than the control group （ P 〈0.05）. Conclusion Danji Huoxue decoction combined with entecavir tablets is effective in the treatment of hepatitis B cirrhosis, which can effectively improve liver function, inflammatory response and bilirubin levels, and has high clinical safety.