五灵胶囊联合恩替卡韦治疗乙肝肝硬化代偿期患者疗效观察

Curative Effect of Wuling Capsule combined with Entecavir in Treatment of Patients with Compensatory Hepatitis B Cirrhosis

目的:探讨五灵胶囊联合恩替卡韦治疗乙肝肝硬化代偿期患者的疗效。方法:将2019年4月至2020年4月收治的乙肝肝硬化患者110例随机分为对照组(n=50)和研究组(n=60),分别予恩替卡韦单药治疗和五灵胶囊联合恩替卡韦治疗,均连续治疗48周。比较两组治疗后HBVDNA转阴率、肝功能指标丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TB)、直接胆红素(DB)、肝右叶斜径、门脉内径、脾厚径、脾长径以及肝脏硬度的变化。结果:两组抗病毒有效率均高达90%以上,治疗后HBVDNA转阴率无明显差异;两组肝功能均有恢复,研究组治疗24周血清ALT、AST、TB较对照组明显好转(P<0.05);研究组的肝脏硬度Fibroscan测定值在治疗48周时较对照组明显改善(P<0.05)。结论:五灵胶囊联合恩替卡韦治疗乙肝肝硬化代偿期患者的肝功能改善快速,肝纤维化改善明显,抗病毒联合抗肝纤维化治疗可更好的逆转肝纤维化。

Objective:To explore the efficacy of Wuling capsule combined with entecavir in the treatment of patients with compensated hepatitis B cirrhosis.Methods:110 patients with compensated hepatitis B cirrhosis admitted to our hospital from Apr 2019 to Apr 2020 were randomly divided into control group(n=50)and study group(n=60),treated with entecavir alone and Wuling capsule combined with entecavir for 48 weeks respectively.After the treatment,HBVDNA negative conversion rate,liver function indexes such as alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TB),direct bilirubin(DB),oblique diameter of right lobe of liver,inner diameter of portal vein,spleen thickness diameter,spleen length diameter and liver hardness were compared between the two groups.Results:The antiviral effective rate in both groups were more than 90%,and there was no difference in HBVDNA negative conversion rate between the two groups after the treatment.Liver function recovered well in both groups.ALT,AST and TB in the study group improved significantly than those in the control group after 24 weeks treatment(P<0.05).Liver hardness FIBROSCAN in the study group was significantly improved than that in the control group after 48 weeks treatment(P<0.05).Conclusion:Wuling capsule combined with entecavir in the treatment of patients with compensated hepatitis B cirrhosis showed rapid improvement in liver function and significant improvement in liver fibrosis.It can be seen that antiviral combined with anti⁃liver fibrosis treatment can better reverse liver fibrosis.