复方鳖甲软肝片联合恩替卡韦对肺结核伴慢性乙肝患者肝纤维化的影响

Effect of compound Biejia Ruangan tablets combined with entecavir on liver fibrosis in patients with pulmonary tuberculosis and chronic hepatitis B

目的探讨复方鳖甲软肝片联合恩替卡韦对肺结核伴慢性乙肝患者肝纤维化的影响。方法选择我院2018年1月至2019年10月收治的60例肺结核伴慢性乙肝患者,根据随机数字表法将其分为对照组和观察组,各30例。两组均实施常规抗结核治疗,在此基础上,对照组给予恩替卡韦,观察组给予恩替卡韦+复方鳖甲软肝片。比较两组的干预效果。结果治疗后,两组患者的血清HA、LN、PCⅢ、Ⅳ-C水平均较治疗前降低,且观察组低于对照组(P<0.05)。观察组的药物性肝损伤发生率低于对照组,病灶吸收率、空洞闭合率、HBV-DNA转阴率及HBeAg转阴率均高于对照组(P<0.05)。结论在肺结核合并慢性乙肝患者的治疗中联合应用恩替卡韦和复方鳖甲软肝片,可降低药物性肝损伤发生率,减轻肝纤维化程度,促使结核病灶吸收、肺部空洞闭合、乙肝病毒转阴。

Objective To investigate the effect of compound Biejia Ruangan tablets combined with entecavir on liver fibrosis in patients with pulmonary tuberculosis and chronic hepatitis B.Methods Sixty patients with pulmonary tuberculosis and chronic hepatitis B in our hospital from January 2018 to October 2019 were selected and divided into control group and observation group according to random number table method,with 30 cases in each group.The two groups were given routine anti-tuberculosis treatment,on this basis,the control group was given entecavir,and the observation group was given entecavir+compound Biejia Ruangan tablets.The intervention effects of the two groups were compared.Results After treatment,the levels of serum HA,LN,PCⅢ,Ⅳ-C of the two groups were lower than those before treatment,and those of the observation group were lower than the control group(P<0.05).The incidence of drug-induced liver injury in the observation group was lower than that in the control group,and the lesion absorption rate,cavity closure rate,HBV-DNA negative rate and HBeAg negative rate in the observation group were higher than those in the control group(P<0.05).Conclusion Entecavir combined with compound Biejia Ruangan tablets in the treatment of patients with pulmonary tuberculosis and chronic hepatitis B can decrease the incidence of drug-induced liver injury,reduce the degree of liver fibrosis,and promote the absorption of tuberculosis lesions,the closure of pulmonary cavities,and the negative conversion of hepatitis B virus.