三药联合治疗乙型肝炎肝硬化疗效探讨

Therapeutic Effect of Three Drugs in the Treatment of Hepatitis B Cirrhosis

目的探讨恩替卡韦分散片(润众)与甘草酸二铵肠溶胶囊(天晴甘平)及扶正化瘀胶囊三药联合治疗乙型肝炎肝硬化疗效。方法选择该院于2016年4月—2017年4月收治104例乙型肝炎肝硬化患者,随机分为两组,每组52例,两组患者入院均行常规治疗与护理,对照组行恩替卡韦分散片(润众)单药治疗,联合组行恩替卡韦分散片(润众)、甘草酸二铵肠溶胶囊(天晴甘平)、扶正化瘀胶囊三药联合治疗,疗程均为1年。观察两组患者治疗前后Vs值。结果治疗前单药组与联合组的Vs值分别为(1.83±0.22)、(1.90±0.23)m/s,治疗后分别为(1.51±0.19)m/s、(1.30±0.13)m/s,经研究,两组患者干预前Vs值差异无统计学意义(t=1.586 0,P>0.05),治疗后两组患者Vs值均明显降低,前后对比差异有统计学意义(t=7.938 2、16.376 7,P<0.05),联合组Vs值明显低于单药组(t=6.577 8,P<0.05)。单药组IV-C、LN、HA、PCIII分别为(175.33±28.44)、(148.71±42.31)、(197.28±54.23)、(208.42±44.31)μg/mL,联合组分别为(112.47±24.29)、(104.36±33.25)、(99.64±25.45)、(147.30±30.94)μg/mL。联合组患者肝纤维化四项指标(IV-C、LN、HA、PCIII)均优于单药组(t=12.119 7、5.943 2、95.621 8、8.155 4,P<0.05)。两组不良反应发生情况比较差异无统计学意义(P>0.05)。结论三药联合治疗乙型肝炎肝硬化效果显著,可显著改善患者肝硬化与纤维化情况,且不增加不良反应发生率,具备深入研究与推广应用价值。

Objective To investigate the efficacy of entecavir dispersible tablets (Runzhong) combined with diammonium glycyrrhizinate enteric-coated capsules (Tianqing Ganping) and Fuzheng Huayu Capsule in the treatment of hepatitis B cirrhosis. Methods From April 2016 to April 2017, 104 patients with hepatitis B cirrhosis were randomly divided into two groups, 52 patients in each group. Both groups received routine treatment and nursing, and the control group was entecavir dispersed tablet (Runzhong) monotherapy, combined group of entecavir dispersible tablets (Runzhong), diammonium glycyrrhizinate enteric-coated capsules (Tianqing Ganping), Fuzheng Huayu Capsule combination therapy, the course of treatment was 1 year. The Vs values of the two groups before and after treatment were observed. Results The Vs values of the single-agent group and the combined group before treatment were(1.83±0.22) and (1.90±0.23)m/s, respectively, and were (1.51±0.19) and (1.30±0.13)m/s after treatment. There was no significant difference in Vs between the two groups (t=1.586 0, P>0.05). After treatment, the Vs values of the two groups were significantly lower, before and after comparison (t=7.938 2, 16.376 7, P<0.05). The Vs value of the combined group was significantly lower than that in the single drug group (t=6.577 8, P<0.05). The monotherapy group IV-C, LN, HA, PCIII were (175.33±28.44),(148.71±42.31),(197.28±54.23),(208.42±44.31)μg/mL, respectively, and the combined group was (112.47±24.29),(104.36±33.25),(99.64±25.45),(147.30±30.94)μg/mL. The four indexes of liver fibrosis (IV-C, LN, HA, PCIII) in the combined group were superior to the single-agent group (t=12.119 7, 5.943 2, 95.621 8, 8.155 4, P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion The combination of three drugs has a significant effect on the treatment of hepatitis B cirrhosis, which can significantly improve the cirrhosis and fibrosis of patients, and does not increase the incidence of adverse reactions. It has in-depth research and popularization and application value.