克癀胶囊对乙型肝炎肝硬化代偿期肝脏硬度值的疗效及影响因素

Effect of Kehuang Capsule on Liver Stiffness of Hepatitis B Cirrhosisin Compensation Period

[目的]观察克癀胶囊对乙型肝硬化代偿期患者的肝脏硬度的疗效及影响因素。[方法]选取2014年1月-2018年1月广东省中西医结合医院门诊初治的乙肝肝硬化代偿期患者进行回顾性研究,所有纳入的病例均予恩替卡韦/替诺福韦酯抗病毒治疗,根据其是否联合服用克癀胶囊,分为观察组及对照组,每组32人。观察两组患者在治疗前、治疗3个月、半年时的肝功能、乙肝病毒DNA及的肝脏硬度等指标,并用多因素Logistic回归分析影响克癀胶囊疗效的因素。[结果]与治疗前比较,两组在治疗3个月及半年时,ALT、AST、TBIL及HBV-DNA显著下降,差异具有显著性(P<0.01)。组间比较,治疗3个月时,与对照组比较,观察组TBIL下降具有显著性差异(P<0.01);肝脏硬度值方面,在治疗3个月及半年时,与治疗前比较,观察组肝脏硬度值下降具有显著性差异(P<0.05);而对照组中,治疗至半年时,肝脏硬度值下降才有显著性差异(P<0.05)。多因素Logistic回归分析显示,体重(OR=2.13,CI:1.26~3.51,P=0.042)、基线肝脏硬度值(OR=5.32,CI:2.39~7.21,P=0.002)及基线总胆红素水平(OR=1.67,CI:1.25~1.98,P=0.012)是克癀胶囊对肝脏硬度值疗效的影响因素。[结论]克癀胶囊可能有改善乙肝肝硬化代偿期患者肝脏硬度值的作用;体重、基线肝脏硬度值及总胆红素水平是克癀胶囊疗效的独立影响因素。

[Objective]To observe the clinical efficacy of Kehuang Capsule on influencing factors of hepatitis B cirrhosis in the compensatory stage.[Methods]A retrospective study was conducted on the patients with compensatory hepatitis B cirrhosis who were first treated in our hospital from January 2014 to January 2018.All patients were treated with entecavir/tenofovir dipivoxil antiviral therapy.They were divided into observation group and control group according to whether they took Kehuang Capsule or not,with 32 patients in each group.The liver function,hepatitis B virus DNA and liver stiffness were observed before treatment,3 and 6 months after treatment,and the factors affecting the efficacy of Kehuang Capsule were analyzed by multivariate logistic regression.[Results]Compared with those pre-treatment,ALT,AST,TBIL and HBV-DNA decreased significantly in the two groups after 3 and 6 months treatment(P<0.01).Compared with the control group,the TBIl of the observation group decreased significantly after 3 months treatment(P<0.01).The liver stiffness of the observation group decreased significantly after 3 and 6 monthstreatment(P<0.05)compared with that pre-treatment(P<0.05)while in the control group,the liver stiffness decreased significantly after 6 months treatment(P<0.05).There was significant difference only when the liver stiffness decreased(P<0.05).Multivariate regression analysis indicated that body weight(OR=2.13,CI:1.26-3.51,P=0.042),baseline liver stiffness(OR=5.32,CI:2.39-7.21,P=0.002)and baseline total bilirubin level(OR=1.67,CI:1.25-1.98,P=0.012)were the influencing factors of the curative effect of Kehuang Capsule on liver stiffness.[Conclusion]Kehuang Capsule may relieveliver stiffness of hepatitis B cirrhosis in the compensatory period.Weight,baseline Liver stiffness and total bilirubin level are in-dependent factors affecting the efficacy of Kehuang Capsule.