恩替卡韦联合鳖甲煎丸治疗慢性乙型肝炎的效果观察

Effects of Entecavir combined with Biejiajian Pills on patients with Hepatitis

目的:观察恩替卡韦联合鳖甲煎丸治疗慢性乙型肝炎的效果。方法:选取2018年1月—2021年11月山东第一医科大学第二附属医院收治的116例慢性乙肝患者,采用随机数表法将患者分为对照组和研究组各58例,对照组口服恩替卡韦分散片治疗,研究组在对照组治疗基础上联合鳖甲煎丸口服治疗,治疗时间96周。观察两组的临床疗效以及治疗前后谷丙转氨酶(BPT)、谷草转氨酶(AST)、谷草转氨酶与血小板比率指数(APRI)、肝脏硬度值(LSM)及肝纤维化指标透明质酸酶(HA)、Ⅳ型胶原(Ⅳ-C)、Ⅲ型前胶原(PCⅢ)、层粘连蛋白(LN)的水平变化;观察两组患者治疗24、48、72、96周后的乙肝病毒的脱氧核糖核酸(HBV-DNA)水平变化情况。结果:治疗96周后,研究组总有效率(89.66%)高于对照组(74.13%),差异有统计学意义(P<0.05);治疗96周后,两组患者ALT、AST水平及APRI、LSM均显著下降,且研究组ALT、AST水平及APRI、LSM显著低于对照组(P<0.05)。治疗24、48、72、96周后,两组患者HBV-DNA水平均逐步下降,且研究组HBV-DNA水平均显著低于对照组(P<0.05)。治疗后,研究组患者HA、Ⅳ-C、PCⅢ、LN水平均显著低于对照组(P<0.05)。结论:恩替卡韦联合鳖甲煎丸长期治疗乙肝肝硬化代偿期患者疗效显著,可以减轻患者肝纤维化程度,改善患者肝脏相关指标,逆转肝硬化。

Objective To evaluate the improvement of liver related indicators and fibrosis indicators in patients with Hepatitis B after Entecavir combined with Biejiajian Pills.Methods 116 patients admitted to the Department of Infectious Diseases of the Second Affiliated Hospital of Shandong First Medical University were selected as the study subjects.The patients were divided into the control group and the study group according to the method of random number table,58 cases in each group.The patients in the control group took Entecavir dispersible tablets orally.On this basis,the study group took Biejiajian Pills orally.The study time was 96 weeks.The clinical efficacy of the two groups after treatment,as well as the alanine aminotransferase(ALT)before and after treatment were observed.The changes of AST,APRI,LSM and the levels of hyaluronidase(HA),typeⅣcollagen(Ⅳ-C),typeⅢprocollagen(PCⅢ)and laminin(LN)were observed;The changes of Hepatitis B virus deoxyribonucleic acid(HBV-DNA)levels were observed after 24,48,72 and 96 weeks of treatment in the two groups.Results After treatment,the total effective rate of the study group(89.66%)was higher than that of the control group(74.13%)(P<0.05);After 96 weeks of treatment,the levels of ALT,AST,APRI and LSM in the two groups were significantly decreased,and the levels of ALT,AST,APRI and LSM in the study group were significantly lower than those in the control group(P<0.05).After 24,48,72 and 96 weeks of treatment,the level of HBV-DNA in the two groups decreased gradually,and the level of HBV-DNA in the study group was significantly lower than that in the control group(P<0.05).After treatment,the levels of HA,Ⅳ-C,PCⅢand LN in the study group were significantly lower than those in the control group(P<0.05).Conclusion Entecavir combined with Biejiajian Pills has a significant effect on the long-term treatment of patients with compensated Hepatitis B cirrhosis.It can reduce the degree of liver fibrosis,improve liver-related indicators,and reverse cirrhosis.