九味肝泰胶囊联合恩替卡韦抗病毒治疗慢性乙型肝炎肝硬化临床观察

Clinical Observation of Jiuwei Gantai Capsule Combined with Entecavir in the Treatment of Chronic Hepatitis B Cirrhosis

目的观察九味肝泰胶囊联合恩替卡韦抗病毒治疗慢性乙型肝炎肝硬化的效果及对肝功能、肝纤维化指标的影响。方法选择2017年11月-2019年3月收治的慢性乙型肝炎肝硬化115例,根据治疗方法分为观察组60例和对照组55例,对照组给予恩替卡韦抗病毒治疗,观察组在对照组基础上给予九味肝泰胶囊治疗,疗程均为6个月。比较2组临床疗效,治疗前及治疗后肝功能指标[丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBIL)],肝纤维化指标[透明质酸(HA)、Ⅳ型胶原(C-Ⅳ)、层黏蛋白(LN)、Ⅲ型前胶原N末端肽(PC-Ⅲ)及超声弹性模量值],及治疗期间不良反应发生情况。结果观察组治疗后总有效率高于对照组(P<0.05)。治疗后,2组血清ALT、AST、TBIL水平、HA、LN、PC-Ⅲ、C-Ⅳ及超声弹性模量均较治疗前降低,且观察组低于对照组(P<0.05,P<0.01)。2组治疗期间不良反应总发生率比较差异无统计学意义(P>0.05)。结论九味肝泰胶囊联合恩替卡韦抗病毒治疗能有效提高慢性乙型肝炎肝硬化临床疗效,改善肝功能、减轻肝纤维化程度,同时具有良好的安全性。

Objective To observe the effect of Jiuwei Gantai capsule combined with Entecavir in the treatment of chronic hepatitis B cirrhosis and its influence on liver function and liver fibrosis index. Methods A total of 115 patients with chronic hepatitis B cirrhosis admitted to our hospital from November 2017 to March 2019 were enrolled and divided into observation group( n = 60) and control group( n = 55) according to different treatment methods. Observation group was treated with Jiuwei Gantai capsule combined with Entecavir anti-virus treatment,while control group was given Entecavir anti-virus treatment alone. The course of treatment was 6 months. The liver function indexes [alanine aminotransferase( ALT),aspartate aminotransferase( AST),total bilirubin( TBIL) ] and liver fibrosis indexes [hyaluronic acid( HA),type Ⅳ collagen( C-Ⅳ),laminin( LN),N-terminal peptide of type Ⅲ procollagen( PC-Ⅲ) ]were compared before and at 6 months after treatment,and the adverse reactions during treatment were compared. Results The total effective rate of the observation group was higher than that of the control group( P < 0. 05). After treatment,the levels of Al T,AST,TBIL,HA,LN,PC-Ⅲ,C-Ⅳ and ultrasonic modulus of elasticity in the two groups were significantly lower than those before treatment,and the above indicators in observation group were lower than those in the control group( P < 0. 05,P < 0. 01). There was no significant difference in the total incidence of adverse reactions between the two groups( P > 0. 05). Conclusion Jiuwei Gantai capsule combined with antiviral treatment with Entecavir can effectively improve the clinical efficacy of patients with chronic hepatitis B cirrhosis,significantly improve the liver function,reduce the degree of liver fibrosis,and has good therapeutic safety.