乙肝抗纤汤联合恩替卡韦治疗乙肝肝硬化代偿期临床研究

Clinical Study on Yigan Kangxian Tang Combined with Entecavir for Hepatitis B Cirrhosis During Compensatory Phase

目的:观察乙肝抗纤汤联合恩替卡韦治疗乙肝肝硬化代偿期的临床疗效。方法:选取60例乙肝肝硬化代偿期患者,采用随机数字表法分为对照组和观察组各30例。对照组给予恩替卡韦治疗,观察组在对照组基础上给予乙肝抗纤汤治疗,2组均治疗3个月。比较2组临床疗效与治疗前后炎症因子、肝功能指标、肝纤维化指标水平和肝硬度测定(LSM)值。结果:观察组总有效率90.00%,高于对照组66.67%(P<0.05)。治疗后,2组白细胞介素-6(IL-6)、白细胞介素-8(IL-8)水平均较治疗前降低(P<0.05),干扰素-γ(INF-γ)、白细胞介素-10(IL-10)水平均较治疗前升高(P<0.05);观察组IL-6、IL-8水平均低于对照组(P<0.05),INF-γ、IL-10水平均高于对照组(P<0.05)。治疗后,2组总胆红素(TBil)、谷丙转氨酶(ALT)、谷草转氨酶(AST)水平均较治疗前降低(P<0.05),白蛋白(Alb)水平均较治疗前升高(P<0.05);观察组TBil、ALT、AST水平均低于对照组(P<0.05),Alb水平高于对照组(P<0.05)。治疗后,2组透明质酸(HA)、层黏蛋白(LN)、Ⅳ型胶原(Ⅳ-C)水平均较治疗前降低(P<0.05),LSM值均较治疗前减小(P<0.05);观察组HA、LN、Ⅳ-C水平均低于对照组(P<0.05),LSM值小于对照组(P<0.05)。结论:乙肝抗纤汤联合恩替卡韦治疗乙肝肝硬化代偿期疗效较好,可有效改善患者的肝功能,抑制炎症反应及肝纤维化。

Objective:To observe the clinical effect of Yigan Kangxian tang combined with entecavir for hepatitis B cirrhosis during compensatory phase.Methods:A total of 60 cases of patients with hepatitis B cirrhosis during compensatory phase were selected and divided into the control group and the observation group according to the random number table method,with 30 cases in each group.The control group was treated with entecavir,and the observation group was additionally treated with Yigan Kangxian tang based on the treatment of the control group.Both groups were treated for three months.The levels of inflammatory factors,liver function indexes and liver fibrosis indexes and the values of liver stiffness measure(LSM)before and after treatment as well as the clinical effects in the two groups were compared.Results:The total effective rate was 90.00%in the observation group,higher than that of 66.67%in the control group(P<0.05).After treatment,the levels of interleukin-6(IL-6)and interleukin-8(IL-8)in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of interferon-γ(INF-γ)and interleukin-10(IL-10)were increased(P<0.05);the levels of IL-6 and IL-8 in the observation group were lower than those in the control group(P<0.05),and the levels of INF-γand IL-10were higher(P<0.05).After treatment,the levels of total bilirubin(TBil),alanine aminotransferase(ALT)and aspartate aminotransferase(AST)in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of albumin(Alb)were increased(P<0.05);the levels of TBil,ALT and AST in the observation group were lower than those in the control group(P<0.05),and the level of Alb was higher(P<0.05).After treatment,the levels of hyaluronic acid(HA),laminin(LN)and collagen of typeⅣ(Ⅳ-C)and the values of LSM in the two groups were decreased when compared with those before treatment(P<0.05);the levels of HA,LN andⅣ-C and the value of LSM in the observation group were lower than those in the control group(P<0.05).Conclusion:The therapy of Yigan Kangxian tang combined with entecavir for hepatitis B cirrhosis during compensatory phase can effectively improve liver function,and inhibit inflammatory responses and liver fibrosis.