恩替卡韦片加用疏肝化瘀汤治疗乙肝肝纤维化患者的效果研究

Effect of Shugan Huayu Decoction on Patients with Hepatitis B Liver Fibrosis

目的:探讨恩替卡韦片加用疏肝化瘀汤治疗乙肝肝纤维化患者的效果。方法:选择本院2017年4月—2020年1月收治的102例乙肝肝纤维化患者,根据治疗方法分为对照组和研究组,各51例。对照组口服恩替卡韦治疗,研究组在对照组基础上给予疏肝化瘀汤治疗,比较两组临床疗效、肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)]、肝纤维化指标[透明质酸(HA)、层黏蛋白(LN)、Ⅲ型前胶原(PC-Ⅲ)、Ⅳ型胶原(Ⅳ-C)]、T淋巴细胞亚群分布(CD3^(+)、CD4^(+)、CD8^(+)、CD44^(+)/CD8^(+))水平及不良反应发生情况。结果:研究组治疗总有效率为96.08%,高于对照组的82.35%(P<0.05)。研究组治疗后血清中ALT、AST、TBIL、HA、LN、PC-Ⅲ、Ⅳ-C和MMP-2水平以及外周血CD8^(+)比例低于治疗前,CD3^(+)、CD4^(+)比例和CD4^(+)/CD8^(+)高于对照组(P<0.05)。两组治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论:在恩替卡韦治疗基础上加用疏肝化瘀汤能够提高乙肝肝纤维化治疗效果,明显改善肝功能和免疫功能,逆转肝纤维化过程,安全性高。

Objective:To investigate the clinical efficacy of Shugan Huayu decoction in the treatment of chronic hepatitis B liver fibrosis.Methods:A total of 102 patients with hepatitis B liver fibrosis admitted to our hospital from April 2017to January 2020 were selected and divided into control group and study group according to the treatment method,with 51cases in each group.The control group was treated with oral entecavir,and the study group was treated with Shugan Huayu decoction on the basis of the control group.The clinical efficacy,liver function indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL)],liver fibrosis indexes[hyaluronic acid(HA),laminin(LN),typeⅢprocollagen(PC-Ⅲ),typeⅣcollagen(Ⅳ-C)],T lymphocyte subsets distribution(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+))levels and adverse reactions were compared between the two groups.Results:The total effective rate of treatment was 96.08%in the study group,which was higher than that of 82.35%in the control group(P<0.05).The serum levels of ALT,AST,TBIL,HA,LN,PC-Ⅲ,Ⅳ-C and MMP-2 and the peripheral blood CD8^(+)ratio were lower in the study group after treatment than before treatment,and the CD3^(+),CD4^(+)ratio and CD4^(+)/CD8^(+)were higher than those in the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions during treatment between the two groups(P>0.05).Conclusion:On the basis of entecavir treatment,Shugan Huayu decoction can improve the therapeutic effect of hepatitis B liver fibrosis,significantly improve liver function and immune function,reverse the process of liver fibrosis,and have high safety.