活血柔肝法联合恩替卡韦治疗乙型肝炎肝硬化的临床观察

Effect of Huoxue Rougan method combined with entecavir on curative effect of hepatitis B and cirrhosis

目的:探讨活血柔肝法联合恩替卡韦治疗乙型肝炎肝硬化的疗效。方法:选取2017年1月至2019年7月我院就诊的124例HBC患者进行研究,随机数字表法将患者分为观察组、对照组,每组62例。对照组患者口服恩替卡韦;观察组患者在口服恩替卡韦的基础上加用活血柔肝法治疗。治疗结束后比较两组患者的疗效、肝功能、肝纤维化指标的变化。结果:治疗48周后,观察组患者总有效率(88.71%),高于对照组(74.19%),差异有统计学意义(P<0.05)。治疗后两组患者AST、ALT、TBil、Alb水平均下降,观察组患者AST、ALT、TBil、Alb水平均低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者CⅣ、PCⅢ、LN、HA水平均下降;观察组CⅣ、PCⅢ、LN、HA水平均低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者HBV DNA拷贝数、肝脏弹性指数均下降,观察组患者HBV DNA拷贝数、肝脏弹性指数低于对照组,差异有统计学意义(P<0.05)。观察组HBV转阴率(95.16%)高于对照组(83.87%),差异有统计学意义(P<0.05)。观察组肝表面形态、肝实质结节或颗粒、脾肿大改善率高于对照组,差异有统计学意义(P<0.05)。结论:活血柔肝法联合恩替卡韦治疗HBC患者的疗效较为显著,能够明显地改善患者肝功能和肝纤维化水平,对于控制和减缓病情有重要的意义。

Objective:To explore the effect of Huoxue Rougan method combined with Entecavir on the curative effect of hepatitis B cirrhosis(HBC)patients.Methods:A total of 124 patients with HBC from January 2017 to July 2019 were selected for the study.They were randomly divided into observation group and control group,with 62 cases in each group.The control group received entecavir orally;the observation group received entecavir orally with Huoxue Rougan method.The curative effect,liver function,liver fiber index,etc.were compared between the two groups.Results:After 48 weeks of treatment,the total effective rate in observation group(88.71%)was significantly higher than that in control group(74.19%)(P<0.05).After treatment,the levels of AST,ALT,TBil and Alb in two groups were decreased,and the levels of AST,ALT,TBil and Alb in observation group were lower than those in control group,the difference was significant(P<0.05).After treatment,the levels of CⅣ,PCⅢ,LN and HA in two groups decreased.The levels of CⅣ,PCⅢ,LN and HA in observation group were significantly lower than those in control group(P<0.05).After treatment,HBV DNA copy number and liver elasticity index in two groups were decreased,and HBV DNA copy number and liver elasticity index in observation group were lower than those in control group,the difference was significant(P<0.05).The negative rate of HBV in observation group(95.16%)was significantly higher than that in control group(83.87%)(P<0.05).The improvement rate of liver surface morphology,liver parenchyma nodules or granules and splenomegaly in observation group was significantly higher than that in control group(P<0.05).Conclusion:The combination of Huoxue Rougan method combined with entecavir was effective in treating patients with HBC.It significantly improved liver function and fibrosis,and was of great significance to control and slow down the disease.