复方牛胎肝提取物片联合抗病毒治疗在乙型肝炎早期肝硬化患者中的临床效果

Clinical effect of compound embryonic bovine liver extract tablets combined with antiviral therapy on patients with hepatitis B early cirrhosis

目的探讨复方牛胎肝提取物片联合抗病毒药物治疗乙型肝炎早期肝硬化的临床效果。方法选取2018年9月至2020年1月哈尔滨医科大学附属第一医院收治的96例乙型肝炎早期肝硬化患者。根据随机数字表法分为对照组和观察组,各48例。对照组采用常规抗病毒方案治疗,观察组采用复方牛胎肝提取物片联合抗病毒治疗,均持续治疗1个月。比较2组肝硬度值、肝功能指标、肝硬化指标、免疫功能指标、肠道菌群数量及不良反应。结果治疗后观察组肝硬度值、丙氨酸转氨酶、天冬氨酸转氨酶、Ⅲ型前胶原、Ⅳ型胶原蛋白水平均低于对照组[(13.5±2.7)kPa比(21.4±3.1)kPa、(49±32)U/L比(58±33)U/L、(36±21)U/L比(50±36)U/L、(104±9)μg/L比(127±11)μg/L、(59±10)μg/L比(86±11)μg/L],差异均有统计学意义(均P<0.05)。治疗后2组CD^(+)_(3)、CD^(+)_(4)、CD^(+)_(4)/CD^(+)_(8)比值均较治疗前上升、且观察组高于对照组,CD^(+)_(8)值均较治疗前下降、且观察组低于对照组,双歧杆菌、乳杆菌数量均较治疗前增加、且观察组多于对照组,肠杆菌、肠球菌、梭菌数量均较治疗前减少、且观察组少于对照组,差异均有统计学意义(均P<0.05)。观察组与对照组不良反应发生率差异无统计学意义[6.2%(3/48)比8.3%(4/48)](P>0.05)。结论复方牛胎肝提取物片联合抗病毒药物治疗可有效改善乙型肝炎早期肝硬化患者肝功能,并可提高机体免疫力,改善肠道微生态环境,且联合用药方案安全。

Objective To investigate the clinical effect of compound embryonic bovine liver extract tablets combined with antiviral therapy on patients with hepatitis B early cirrhosis.Methods From September 2018 to January 2020,96 patients with hepatitis B early cirrhosis admitted to the First Affiliated Hospital of Harbin Medical University were enrolled.They were divided into observation group and control group according to the random number table method,with 48 cases in each group.The control group was treated with routine antiviral treatment and the observation group was treated with compound embryonic bovine liver extract tablets combined with antiviral therapy,all for 1 month.The liver stiffness measurements,liver function indexes,liver cirrhosis indexes,immune function indexes,intestinal flora number and adverse reactions were compared between the two groups.Results After treatment,the liver stiffness measurements,alanine aminotransferase,aspartate aminotransferase,typeⅢprocollagen and typeⅣcollagen levels in the observation group were lower than those in the control group[(13.5±2.7)kPa vs(21.4±3.1)kPa,(49±32)U/L vs(58±33)U/L,(36±21)U/L vs(50±36)U/L,(104±9)μg/L vs(127±11)μg/L,(59±10)μg/L vs(86±11)μg/L](all P<0.05).After treatment,the levels of CD^(+)_(3),CD^(+)_(4),CD^(+)_(4)/CD^(+)_(8)ratio in the two groups were higher than those before treatment,and those in the observation group were higher than those in the control group;CD^(+)_(8)level in the two groups was lower than that before treatment,and that in the observation group was lower than that in the control group;the number of bifidobacteria and lactobacillus in the two groups were higher than those before treatment,and those in the observation group were more than those in the control group;the number of enterobacter,enterococcus and clostridium were less than those before treatment,and those in the observation group were less than those in the control group(all P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group[6.2%(3/48)vs 8.3%(4/48)](P>0.05).Conclusions Compound embryonic bovine liver extract tablets combined with antiviral therapy can effectively improve the liver function of patients with hepatitis B early cirrhosis,improve the body immunity and intestinal micro ecological environment,and the combined medication scheme is safe.