扶正化瘀胶囊联合恩替卡韦片治疗慢乙肝肝硬化瘀血阻络证患者临床观察

Clinical observation of fuzheng huayu capsule combined with entecavir tablet in treating patients with chronic hepatitis b cirrhosis with blood stasis and collaterals obstruction

目的观察扶正化瘀胶囊联合恩替卡韦片治疗慢乙肝肝硬化瘀血阻络证患者的临床疗效。方法用随机数字表法在2015年01月至2018年06月期间在我院收治的80例慢乙肝肝硬化瘀血阻络证患者分为对照组、观察组,每组40例;对照组予恩替卡韦片治疗,观察组在对照组的基础上加服扶正化瘀胶囊治疗;两组共治疗48周。比较两组患者治疗前、治疗24周及治疗48周后中医证候积分、肝功能(总胆红素、白蛋白、丙氨酸氨基转移酶、门冬氨酸氨基转移酶)、肝纤四项(透明质酸酶、Ⅲ型前胶原、Ⅳ型胶原、层粘连蛋白)、凝血功能(凝血酶原时间、活化部分凝血活酶时间、凝血酶时间、纤维蛋白原)、细胞免疫功能(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、炎症因子(TNF-α、IL-1β、IL-6、hs-CRP)、无创肝纤维化指标(APRI、FIB4、RPR、LSM)。结果治疗48周,对照组完成36例;观察组完成35例;观察组总有效率为88.57%,显著高于对照组总有效率72.97%(P<0.05)。与治疗前比较,治疗24周、48周两组患者的中医证候积分、肝功能、肝纤维化指标、细胞免疫功能、炎症因子各项指标均显著改善(P<0.05);治疗48周两组患者凝血功能显著改善(P<0.05)。与对照组比较,治疗48周观察组患者中医证候积分、肝功能、肝纤维化指标、细胞免疫功能、凝血功能、炎症因子各项指标均显著改善(P<0.05)。结论扶正化瘀胶囊联合恩替卡韦片对乙肝肝硬化瘀血阻络证患者疗效显著,具有护肝降酶、抗肝纤维化、改善凝血功能、提高细胞免疫以及减轻肝脏炎症反应等作用。

Objective To observe the clinical effect of Fuzheng Huayu capsule combined with entecavir in the treatment of chronic hepatitis B cirrhosis with blood stasis syndrome.Methods 80 cases of chronic hepatitis B cirrhosis with blood stasis syndrome admitted in our hospital from January 2015 to June 2018 were divided into control group and observation group with 40 cases in each group;the control group was treated with entecavir,and the observation group was treated with Fuzheng Huayu Capsule on the basis of the control group;the two groups were treated for 48 weeks.The TCM syndrome score,liver function(total bilirubin,albumin,alanine aminotransferase,aspartate aminotransferase),liver fiber(hyaluronidase,procollagenⅢ,procollagenⅣ,laminin egg white),coagulation function(prothrombin time,activated partial thromboplastin time,thrombin time)were compared between the two groups Fibrinogen,cellular immune function(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),inflammatory factors(TNF-α,IL-1β,IL-6,hsCRP),non-invasive liver fibrosis index(Apri,fib4,RPR,LSM).Results After 48 weeks of treatment,36 cases in the control group,35 cases in the observation group,and the total effective rate in the observation group was 88.57%,significantly higher than that in the control group(72.97%)(P<0.05).Compared with that before treatment,the TCM syndrome score,liver function,liver fibrosis index,cellular immune function and inflammatory factor index of the two groups were significantly improved(P<0.05);the coagulation function of the two groups was significantly improved(P<0.05)at 48 weeks.Compared with the control group,the TCM syndrome score,liver function,liver fibrosis index,cellular immune function,coagulation function and inflammatory factor index in the observation group were significantly improved(P<0.05).Conclusion Fuzheng Huayu capsule combined with entecavir tablet has a significant effect on liver cirrhosis patients with blood stasis and collaterals obstruction syndrome.It has the functions of protecting liver,reducing enzyme,anti liver fibrosis,improving coagulation function,improving cell immunity and reducing liver inflammation.