仙珠化纤方联合恩替卡韦治疗慢性肝纤维化疗效观察

Effect of Xianzhu Huaxian formula combined with entecavir on chronic hepatic fibrosis

目的观察仙珠化纤方联合恩替卡韦治疗慢性肝纤维化的临床疗效。方法选取2016年1月至2019年6月于安康市中医医院治疗的90例慢性肝纤维化患者作为研究对象,采用随机数表法将其分为观察组和对照组各45例,对照组患者给予恩替卡韦治疗,观察组患者在恩替卡韦治疗基础上联合仙珠化纤方治疗,疗程均为48周。比较两组患者治疗前后的肝脏瞬时弹性值(LSM)、脾脏大小(脾静脉内径、肝门静脉内径、脾脏厚度)、血小板比率指数、肝纤维化指标层黏连蛋白(LN)、透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)。结果治疗前,两组患者的LSM值、脾静脉内径、肝门静脉内径、脾脏厚度、血小板比率指数、LN、HA、PCⅢ、Ⅳ-C水平比较差异均无统计学意义(P>0.05);治疗后,两组患者的LSM值、脾脏大小、血小板比率指数、肝纤维化指标水平均降低或减小,且观察组患者的LSM值为(10.31±3.02)kPa,明显低于对照组的(14.33±4.52)kPa,脾静脉内径、肝门静脉内径、脾脏厚度分别为(6.60±1.21)mm、(10.35±1.21)mm、(4.12±1.31)mm,明显小于对照组的(13.34±1.43)mm、(12.59±1.54)mm、(4.68±1.23)mm,血小板比率指数为0.98±0.36,明显低于对照组的1.30±0.41,差异均有统计学意义(P<0.05);治疗后,观察组患者的LN、HA、PCⅢ、Ⅳ-C水平分别为(87.56±21.43)ng/mL、(158.21±26.49)ng/mL、(105.23±22.17)ng/mL、(72.35±23.78)ng/mL,明显低于对照组的(114.25±23.34)ng/mL、(237.56±25.39)ng/mL、(127.85±21.38)ng/mL、(96.71±20.36)ng/mL,差异均有统计学意义(P<0.05)。结论仙珠化纤方联合恩替卡韦治疗慢性肝纤维化可有效降低患者的肝脏弹性纤维化扫描值,使脾脏大小维持在合理范围内,降低血小板比率指数,改善肝纤维化程度,值得推广应用。

Objective To observe the clinical efficacy of Xianzhu Huaxian forumula combined with entecavir in the treatment of chronic liver fibrosis.Methods A total of 90 patients with chronic liver fibrosis who were treated in Ankang Hospital of Traditional Chinese Medicine from January 2016 to June 2019 were selected and divided into the observation group and control group according to random number table method,with 45 cases each group.The patients in the control group were given entecavir treatment,patients in the observation group were treated with Xianzhu Huaxian formula on the basis of entecavir treatment,and the course of treatment was 48 weeks.The instantaneous liver elasticity value(LSM)value,spleen size(splenic vein diameter,hepatic portal vein diameter,spleen thickness),platelet ratio index,liver fibrosis index laminin(LN),transparency Acidic acid(HA),type Ⅲ procollagen(PCⅢ),type Ⅳ collagen(Ⅳ-C)of the two groups of patients were compared before and after treatment.Results Before treatment,there was no significant difference in LSM value,splenic vein diameter,hepatic portal vein diameter,spleen thickness,platelet ratio index,LN,HA,PCⅢ,and IV-C levels between the two groups of patients(all P>0.05);After treatment,the LSM value,spleen size,platelet ratio index,and liver fibrosis index levels of the two groups decreased or decreased.The LSM value of the observation group was(10.31±3.02)kPa,which was significantly lower than(14.33±4.52)kPa of the control group(P<0.05);the inner diameter of the splenic vein,the inner diameter of the hepatic portal vein,and the thickness of the spleen were(6.60±1.21)mm,(10.35±1.21)mm,and(4.12±1.31)mm,respectively,which were significantly smaller than corresponding(13.34±1.43)mm,(12.59±1.54)mm,(4.68±1.23)mm of the control group(P<0.05);platelet ratio index was 0.98±0.36,which was significantly lower than 1.30±0.41 of the control group(P<0.05);after treatment,the levels of LN,HA,PCⅢ,and Ⅳ-C in the observation group were(87.56±21.43)ng/mL,(158.21±26.49)ng/mL,(105.23±22.17)ng/mL,(72.35±23.78)ng/mL,respectively,which were significantly lower than corresponding(114.25±23.34)ng/mL,(237.56±25.39)ng/mL,(127.85±21.38)ng/mL,(96.71±20.36)ng/mL of the control group(all P<0.05).Conclusion In the treatment of chronic liver fibrosis,Xianzhu Huaxian formula combined with entecavir can effectively reduce the scanning value of liver elastic fibrosis,maintain the size of spleen within a reasonable range,reduce the platelet ratio index,and improve the degree of liver fibrosis.It is worthy of popularization and application.