肝爽颗粒联合恩替卡韦治疗慢性乙型肝炎肝硬化临床疗效

Clinical Effect of Ganshuang Granule Combined with Entecavir in the Treatment of Chronic Hepatitis B Cirrhosis

目的:探讨肝爽颗粒联合恩替卡韦治疗慢性乙型肝炎肝硬化的临床效果。方法:选取新乡市传染病医院2019年8月至2021年8月期间收治的60例慢性乙型肝炎肝硬化患者,采用随机数字表法分为对照组与观察组,各30例。对照组患者给予恩替卡韦治疗,观察组患者在对照组基础上给予肝爽颗粒治疗。两组患者的治疗时间均为6个月。对两组患者治疗后的临床疗效、治疗前后的相关细胞因子、肝纤维化、肝功能及乙型肝炎病毒复制情况进行比较。结果:观察组患者治疗总有效率为96.67%,高于对照组的80.00%,差异具有统计学意义(P<0.05)。治疗后两组患者血清白细胞介素–17(IL–17)、IL–35、调节性T细胞(Treg)、IL–23水平均有不同程度降低,且治疗后观察组患者血清IL–17、IL–35、Treg、IL–23水平均低于对照组,差异具有统计学意义(P<0.05)。治疗后两组患者血清透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、Ⅳ型前胶原(IV–C)水平均有不同程度下降,且治疗后观察组患者HA、LN、PCⅢ、IV–C水平均低于对照组,差异具有统计学意义(P<0.05)。治疗后两组患者血清白蛋白(ALB)水平均有不同程度升高,血清总胆红素(TBIL)、乙型肝炎病毒脱氧核糖核酸(HBV–DNA)水平均有不同程度下降,且治疗后观察组患者血清ALB水平高于对照组,血清TBIL、HBV–DNA水平均低于对照组,差异具有统计学意义(P<0.05)。结论:肝爽颗粒联合恩替卡韦治疗慢性乙型肝炎肝硬化可有效减轻患者机体炎症反应,增强免疫能力,改善肝功能,延缓肝硬化进展,抑制乙型肝炎病毒复制,提高治疗效果。

Objective To investigate the clinical effect of Ganshuang granule combined with entecavir in the treatment of chronic hepatitis B cirrhosis.Methods A total of 60 patients with chronic hepatitis B cirrhosis treated in Xinxiang Infectious Disease Hospital from August 2019 to August 2021 were selected and divided into a control group and an observation group by random number table method,with 30 cases in each group.The control group was treated with entecavir,and the observation group was treated with Ganshuang granule on the basis of the control group.The treatment time of the two groups was 6 months.The clinical efficacy after treatment,related cytokines,liver fibrosis,liver function and hepatitis B virus replication condition before and after treatment were compared between the two groups.Results The total effective rate of the observation group was 96.67%,higher than 80.00%of the control group,and the difference was statistically significant(P<0.05).After treatment,the serum levels of interleukin-17(IL-17),IL-35,T regulatory cell(Treg)and IL-23 in the two groups were decreased to varying degrees,and the serum levels of IL-17,IL-35,Treg and IL-23 in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of serum hyaluronic acid(HA),laminin(LN),typeⅢprocollagen(PCⅢ)and typeⅣcollagen(IV-C)in the two groups decreased to varying degrees,and the levels of HA,LN,PCⅢand IV-C in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of serum albumin(ALB)of the two groups were increased to varying degrees,serum total bilirubin(TBIL)and hepatitis B virus deoxyribonucleic acid(HBV-DNA)levels were decreased to varying degrees,and after treatment,serum ALB level of the observation group was higher than that of the control group,serum TBIL and HBV-DNA levels were lower than those of the control group,the differences were statistically significant(P<0.05).Conclusion Ganshuang granule combined with entecavir in the treatment of chronic hepatitis B cirrhosis can effectively reduce the inflammatory response of patients,enhance immune ability,improve liver function,delay the progression of liver cirrhosis,inhibit the replication of hepatitis B virus and improve the therapeutic effect.