棒柄花叶清肝胶囊联合替诺福韦治疗慢性乙肝肝纤维化患者的疗效观察

Observation on the Curative Effect of Bangbing Huaye Qinggan Capsule Combined with Tenofovir in the Treatment of Chronic Hepatitis B Patients with Liver Fibrosis

目的:观察棒柄花叶清肝胶囊联合替诺福韦治疗慢性乙肝肝纤维化患者的临床效果。方法:将120例CHB患者随机分为对照组和治疗组,每组60例。两组患者均给予富马酸替诺福韦二吡呋酯片抗病毒治疗,治疗组加服棒柄花叶清肝胶囊,两组疗程均为48周。观察两组患者治疗前后肝功能血清ALT水平、血清学肝纤维化指标[Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原、透明质酸酶、层粘连蛋白]、非血清学肝纤维化指标:肝脏FibroScan瞬时弹性成像技术测量肝脏硬度值、HBV-DNA水平及阴转率,比较两组的疗效。结果:治疗48周后,两组患者肝功能指标、HBV-DNA水平及阴转率均优于治疗前(均P<0.05),但两组差异均无统计学意义(均P>0.05);治疗后两组患者PCⅢ、CIV、HA、LN水平及肝脏硬度值均低于治疗前(均P<0.05),并且治疗组患者以上各指标水平均低于对照组患者(均P<0.05)。结论:棒柄花叶清肝胶囊联合替诺福韦治疗慢性乙肝肝纤维化患者,能更有效地抑制HBV复制,促进肝脏功能的恢复,减缓肝纤维化的进展。

Objective: To observe the clinical effect of Bangbing Huaye Qinggan capsule combined with tenofovir in the treatment of chronic hepatitis B patients with liver fibrosis. Methods: 120 patients with CHB were randomly divided into control group and treatment group, with 60 cases in each group. Both groups were treated with tenofovir fumarate dipivoxil tablets. The treatment group was treated with Bangbing Huaye Qinggan capsule. The course of treatment of both groups was 48 weeks. The serum ALT level, serological liver fibrosis [type Ⅲ procollagen(PCⅢ), type Ⅳcollagen, hyaluronidase, laminin] and non-serological liver fibrosis index were observed before and after treatment in 2 groups.Liver hardness value, HBV-DNA level and negative conversion rate were measured by hepatic FibroScan transient elastic imaging technology, and the efficacy of the two groups were compared. Results: After 48 weeks of treatment,liver function index, HBV-DNA level and negative turn rate were better than those before treatment(all P<0.05), but there was no significant difference between the two groups(all P>0.05);after treatment, the levels of PCⅢ, CIV, HA, LN and liver hardness in the two groups were lower than those before treatment(all P < 0.05), and the levels of the above indexes in the treatment group were lower than those in the control group(all P < 0.05). Conclusion: Bangbing Huaye Qinggan capsule combined with tenofovir in the treatment of patients with chronic hepatitis B liver fibrosis can more effectively inhibit HBV replication, promote the recovery of liver function and slow down the progress of liver fibrosis.