扶正祛毒方联合抗病毒方案治疗慢性HBV感染相关肝硬化的效果及对HBV-DNA载量的影响

Effectiveness of Fuzheng Qudu Decoction Combined with Antiviral Regimen in the Treatment of Chronic HBV Infection-Related Cirrhosis and the Effect on HBV-DNA Load

目的:分析扶正祛毒方联合抗病毒方案治疗慢性乙型肝炎(HBV)感染相关肝硬化的疗效和对乙型肝炎病毒脱氧核糖核酸(HBV-DNA)载量的影响。方法:选择2019年10月至2021年10月我院收治的慢性HBV感染相关肝硬化患者218例,按照简单随机分组法分为联合组(予以扶正祛毒方联合恩替卡韦抗病毒治疗,n=109)和对照组(予以恩替卡韦抗病毒治疗,n=109例)。治疗12周后比较两组患者的临床疗效和中医证候积分,HBV-DNA载量和阳性率,乙肝表面抗原(HBsAg)和乙肝病毒e抗原(HBeAg)转阴率;比较治疗前后两组肝功能指标[谷丙转氨酶(ALT)、血清白蛋白(ALB)、总胆红素(TBIL)和天冬氨酸氨基转移酶(AST)水平],对比患者血清炎性因子[肿瘤细胞坏死因子(TNF-α)、白细胞介素-6(IL-6)和白细胞介素-8(IL-8)]水平。结果:治疗后,联合组治疗前后各中医症候积分降低幅度高于对照组(P<0.05),且联合组患者临床有效率为92.66%高于对照组的83.49%(P<0.05)。联合组患者HBV-DNA载量治疗前后的降低幅度高于对照组(P<0.05),HBV-DNA、HBsAg和HBeAg转阴率均高于对照组(P<0.05);治疗后,联合组患者ALT、TBIL和AST以及炎性指标TNF-α、IL-6、IL-8水平均较对照组低,ALB高于对照组(P<0.05),且联合组上述指标治疗前后降幅均高于对照组(P<0.05)。结论:扶正祛毒方联合抗病毒治疗慢性HBV相关肝硬化临床疗效显著,可抑制机体炎性反应、提高机体免疫应答,抑制HBV-DNA的复制,降低病毒载量,改善肝功能。

Objective:To analyze the Effectiveness of Fuzheng Qudu decoction combined with antiviral regimen in the treatment of chronic hepatitis B(HBV)infection-related liver cirrhosis and its effect on hepatitis B virus deoxyribonucleic acid(HBV-DNA)load.Methods:A total of 218 patients with chronic HBV infection-related liver cirrhosis treated in the hospital between October 2019 and October 2021 were selected,and they were divided into combined group(given Fuzheng Qudu decoction combined with entecavir antiviral therapy,n=109)and control group(treated with entecavir antiviral therapy,n=109)according to the simple random grouping method.The clinical efficacy and scores of TCM syndromes,HBV-DNA load and positive rate and negative conversion rate of hepatitis B surface antigen(HBsAg)and hepatitis B virus e antigen(HBeAg)of the two groups were compared after 12 weeks of treatment.The levels of liver function indicators[alanine aminotransferase(ALT),serum albumin(ALB),total bilirubin(TBIL),aspartate aminotransferase(AST)]before and after treatment and levels of serum inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8)]were compared between the two groups.Results:The decreases of scores of TCM syndromes before and after treatment were higher in combined group compared to control group(P<0.05),and the clinical effective rate of 92.66%was higher than 83.49%in control group(P<0.05).The decrease of HBV-DNA load before and after treatment in combined group was higher compared with that in control group(P<0.05),and the negative conversion rates of HBV-DNA,HBsAg and HBeAg were higher compared with those in control group(P<0.05).The levels of ALT,TBIL and AST and inflammatory indicators TNF-α,IL-6 and IL-8 in combined group after treatment were lower than those in control group while the level of ALB was higher than that in control group(P<0.05),and the decreases of the above indicators in combined group before and after treatment were higher than those in control group(P<0.05).Conclusion:Fuzheng Qudu decoction combined with antiviral therapy has a significant clinical efficacy in the treatment of chronic HBV-related liver cirrhosis,and it can inhibit the body’s inflammatory response,enhance the body’s immune response,inhibit the HBV-DNA replication,reduce the viral load and improve the liver function.