和络舒肝片联合恩替卡韦治疗对乙肝肝硬化患者肝纤维化的影响

Effect of Heluoshugan tablets combined with entecavir on hepatic fibrosis in patients with hepatitis B-associated cirrhosis

目的 观察和络舒肝片联合恩替卡韦治疗乙肝肝硬化患者肝纤维化的疗效。方法 将180例乙肝肝硬化患者随机分为对照组与联合组,每组90例,对照组给予恩替卡韦治疗,联合组给予和络舒肝片+恩替卡韦治疗,疗程6个月,比较两组临床疗效,血清炎症因子、肝功能以及肝纤维化的变化情况。结果 治疗后,联合组总好转率较对照组明显提高(P<0.05);两组血清IL-6、TNF-α水平明显降低(P<0.01),IL-10、IL-13水平明显升高(P<0.01),与对照组比较,联合组改善幅度更大(P<0.01);两组ALT、AST、TBil水平明显降低(P<0.01),联合组比对照组改善幅度更明显(P<0.01);两组HA、LN、Ⅳ-C以及PC-Ⅲ水平同样明显降低(P<0.01),联合组比对照组改善幅度更大(P<0.01);两组治疗过程中无明显不良反应发生。结论 对乙肝肝硬化患者应用和络舒肝片联合恩替卡韦治疗,能够明显提升临床治愈率,调节患者血清炎症因子水平,改善肝功能,抑制肝纤维化进程,无明显不良反应,安全性较好。

Objective To observe the efficacy of Heluoshugan tablets combined with entecavir in the treatment of liver fibrosis in patients with hepatitis B-associated cirrhosis. Methods Randomized 180 patients with hepatitis B-associated cirrhosis were divided into control group and combined group,with 90 cases in each group.The control group were treated with entecavir,and the combined group were treated with Heluoshugan tablets+entecavir.Both groups were treated for 6 months.The clinical efficacy,serum inflammatory factors,liver functions and liver fibrosis were compared between the two groups. Results After treatment,total improvement rate in the combined group was significantly higher than that in the control group( P < 0.05 ).The levels of serum IL-6 and TNF-α significantly decreased in the two groups( P <0.01),while the levels of IL-10 and IL-13 significantly increased( P <0.01),and the improvement of the combined group was more significant( P <0.01).The levels of ALT,AST and TBil significantly decreased in the two groups( P <0.01),and those in the combined group decreased more significantly( P <0.01).The levels of HA,LN,IV-C and PC-Ⅲ also significantly decreased in the two groups( P < 0.01 ),and the improvement in the combined group was more significant( P <0.01).No obvious adverse reactions were found during treatment between the two groups. Conclusion Heluoshugan tablets combined with entecavir for patients with hepatitis B-associated cirrhosis can significantly improve clinical cure rate,regulate serum inflammatory factors levels,improve liver function and inhibit liver fibrosis,and which has no obvious adverse reactions and has good safety.