顾氏健脾益气柔肝方联合恩替卡韦对代偿期乙肝肝硬化患者疗效及肠道菌群和肠黏膜屏障功能的影响

Effects of Gu's Jianpi Yiqi Rougan Decoction combined with Entecavir on the efficacy,intestinal flora and intestinal mucosal barrier function in patients with compensated hepatitis B liver cirrhosis

目的:观察并分析顾氏健脾益气柔肝方联合恩替卡韦对代偿期乙肝肝硬化患者疗效及肠道菌群、肠黏膜屏障功能的影响。方法:将符合标准的60例代偿期乙肝肝硬化患者随机分为中药组和对照组,对照组30例给予口服恩替卡韦分散片;中药组30例在口服恩替卡韦分散片同时加服顾氏健脾益气柔肝方。观察2组治疗后临床疗效、肝功能.肝纤维化指标、HBV-DNA、肠道菌群以及肠黏膜屏障功能的变化。结果:中药组在改善患者临床疗效上优于对照组。其中2组患者经治疗后,其肝功能指标(ALT、AST、TBIL)、肝纤维化指标、HBV-DNA数值、血清ET、D-乳酸、DAO水平较治疗前均显著下降,但中药组下降更优于对照组;ALB指标较治疗前均升高,但中药组上升更优于对照组;2组患者肠内双歧杆菌、乳杆菌数量均较疗前增多,大肠杆菌数量均较疗前下降,但中药组均优于对照组。结论:在常规西药抗病毒治疗上加用顾氏健脾益气柔肝方口服可提升早期乙肝肝硬化患者疗效。其或依据“肠-肝轴”理论通过调节肠道菌群及修复肠黏膜屏障而起到治疗作用。

Objective: To observe and analyze the effects of Gu’s Jianpi Yiqi Rougan Decoction combined with Entecavir on the efficacy, intestinal flora and intestinal mucosal barrier function in patients with compensated hepatitis B cirrhosis. Methods: Randomly dividing 60 patients with compensated hepatitis B cirrhosis that meet the criteria into two groups, 30 cases of control group: Given oral Entecavir dispersible tablets;30 cases in Traditional Chinese Medicine group: In addition to taking orally Entecavir dispersible tablets and taking Gu’s Jianpi Yiqi Rougan Decoction at the same time. The changes in clinical efficacy, liver function, liver fibrosis indicators, HBV-DNA, intestinal flora, and intestinal mucosal barrier function were observed in the two groups after treatment. Results: The Traditional Chinese Medicine group was better than the control group in improving the clinical efficacy of patients. After treatment, the liver function indexes(ALT, AST, TBIL), liver fibrosis indexes, HBV-DNA value, serum ET, D-lactic acid, and DAO levels of the two groups were significantly decreased compared with those before treatment, but the Traditional Chinese Medicine group decreased. Better than the control group;ALB indexes were all higher than those before treatment, but the increase in the Traditional Chinese Medicine group was better than that in the control group;the number of bifidobacteria and lactobacilli in the intestines of both groups increased than before treatment, and the number of escherichia coli decreased, but the Traditional Chinese Medicine group was better than the control group. Conclusion: Oral administration of Gu’s Jianpi Yiqi Rougan Decoction in addition to conventional Western medicine antiviral therapy can improve the curative effect of patients with early hepatitis B cirrhosis, it may play a therapeutic role by regulating the intestinal flora and repairing the intestinal mucosal barrier according to the theory of "gut-liver axis".