维生素D_3联合复方甘草酸苷恩替卡韦治疗慢性乙型肝炎患者的临床研究

Clinical study of vitamin D_3 combined with compound glycyrrhizin tablets and entecavir in the treatment of chronic hepatitis B patient

目的探讨维生素D_3联合复方甘草酸苷、恩替卡韦对慢性乙型肝炎患者肝功能、肝纤维化及免疫功能的临床观察。方法将60例慢性乙型肝炎患者按随机数字表法分为对照组和观察组,每组各30例,对照组给予复方甘草酸苷、恩替卡韦治疗,观察组在此基础上给予补充维生素D_3治疗。对比2组患者治疗前及治疗6个月后的肝功能、血清中肝纤维化指标、外周血中免疫细胞含量情况。结果治疗6个月后,2组患者肝功能改善,观察组降低程度高于对照组,差异有统计学意义(P <0.05),2组患者透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PⅢ)、Ⅳ型胶原(Ⅳ-C)均降低,观察组降低程度高于对照组,差异有统计学意义(P <0.05),2组患者外周血中CD4^+、CD4^+/CD8^+均升高,观察组升高程度高于对照组,CD8^+均降低,观察组降低程度高于对照组,差异有统计学意义(P <0.05)。结论维生素D_3联合复方甘草酸苷、恩替卡韦治疗慢性乙型肝炎患者能有效改善乙型肝炎患者的肝功能,能够调节免疫应答以及能延缓肝纤维化,值得临床进一步探究。

Objective To investigate the changes of liver function,liver fibrosis and immune function after vitamin D 3 combined with compound glycyrrhizin tablets and entecavir in treatment of patients with chronic hepatitis B.Methods Sixty chronic hepatitis B patients were randomly divided into the control group and the observation group,30 cases in each group.The control group was given compound glycyrrhizin tablets and entecavir,the observation group was given vitamin D3 supplementation on the basis of the control group.The liver function,the serum liver fibrosis index,the contents of immune cells in peripheral blood were detected before treatment and in the six months after treatment.Results After treatment for 6 months,the liver function index decreased in both groups,and the reduction degree of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).HA,LN,PⅢ,Ⅳ-C decreased in both groups,and the reduction degree of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).The CD4+,CD4+/CD8+increased in both groups,the increasing degree of the observation group was higher than that of the control group.CD8+decreased in both groups,and the reduction degree of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).Conclusion Vitamin D 3 combined with compound glycyrrhizin tablets and entecavir could effectively improve the liver function of chronic hepatitis B patients,regulate immune response,and delay liver fibrosis.It is worthy of further clinical promotion.