恩替卡韦联合扶正化瘀胶囊治疗乙肝肝硬化代偿期患者疗效评估

Therapeutic effect of entecavir combined with Fuzheng Huayu capsule on the compensatory period of hepatitis B cirrhosis

目的探讨恩替卡韦联合扶正化瘀胶囊治疗乙肝肝硬化代偿期患者的临床疗效。方法纳入乙肝肝硬化代偿期患者40例,随机分为实验组和对照组,对照组给予恩替卡韦单独治疗,实验组给予恩替卡韦联合扶正化瘀胶囊治疗,比较两组患者在肝脏组织病理学、肝纤维化指标、肝功能等方面的差异。结果实验组患者治疗后Ishak评分降低较对照组明显,影像学检查指标(脾脏长度、脾脏宽度、门脉直径)较对照组缩小,差异均有统计学意义(t分别=-2.10、4.07、3.58、2.65,P均<0.05);而两组治疗后Knodell炎症活动度、肝纤维化指标(Ⅲ型前胶原、Ⅳ型胶原、层粘蛋白、透明质酸)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、血清白蛋白(ALB)、总胆红素(STB)比较,差异均无统计学意义(t分别=0.69、-0.12、-0.74、0.17、0.83、0.34、0.17、0.85、0.27,P均>0.05)。结论恩替卡韦联合扶正化瘀胶囊治疗乙肝肝硬化代偿期可以不同程度逆转肝纤维化程度,延缓肝硬化进程,联合用药优于单一用药。

Objective To investigate the clinical efficacy of entecavir combined with Fuzheng Huayu capsule on the treatment of hepatitis B cirrhosis with compensatory stage.Methods Totally 40 patients with compensated liver cirrhosis were randomly divided into experimental group and control group.The control group was treated with entecavir,and the experimental group was treated with entecavir combined with Fuzheng Huayu capsule.The differences in liver histopathology,liver fibrosis index and liver function between the two groups were compared.Results After treatment,the difference of Ishak score bebore and after treatment of the experimental group was significantly larger than that of the control group,and spleen length,spleen width,and portal vein diameter of the experimental group were significantly shorter than those of the control group(t=-2.10,4.07,3.58,2.65,P<0.05).However,the differences in the Knodell inflammatory activity score,procollagenⅢ,collagenⅣ,laminin,hyaluronic acid,ALT,AST,ALB,and STB between the two groups were not significantly different(t=0.69,-0.12,-0.74,0.17,0.83,0.34,0.17,0.85,0.27,P>0.05).Conclusion Entecavir combined with Fuzheng Huayu capsule can reverse the degree of liver fibrosis and delay the process of liver cirrhosis in different degrees.