鳖甲煎丸治疗代偿期慢性乙型肝炎肝硬化的疗效观察

EfTeet of Bijiajian Pil(鳖甲煎丸)on Compensatory CHB Cirrhosis

目的 探讨鳖甲煎丸治疗代偿期慢性乙型肝炎(CHB)肝硬化患者的疗效。方法 以2018年1月—2020年1月该院收治的代偿期CHB肝硬化患者130例为研究对象,采用随机数字表法分为对照组(65例)和观察组(65例)。对照组进行常规治疗联合恩替卡韦片治疗,观察组在对照组的基础上采用鳖甲煎丸进行治疗,两组均治疗24周。比较两组治疗12、24周后肝功能、病毒学指标及治疗前、治疗24周后肝硬度值及超声影像学检查指标、肝纤维化指标、血清炎性因子水平。结果 治疗24周后,观察组总胆红素(TBIL)、谷丙转氨酶(ALT)/谷草转氨酶(AST)复常率及乙型肝炎病毒-脱氧核糖核酸(HBV-DNA)转阴率高于对照组(P<0.05)。治疗24周后,两组脾脏长度、门静脉内径短于治疗前,观察组短于对照组,脾脏厚度、肝硬度值及血清Ⅲ型前胶原(PC-原)、Ⅳ型胶原(IV-C)、层黏连蛋白(LN)、透明质酸(HA)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)低于治疗前,观察组低于对照组(P<0.05)。结论 鳖甲煎丸治疗代偿期CHB肝硬化患者可有效改善患者肝功能,缓解肝纤维化进程,降低机体炎症反应,改善肝脏和脾脏情况,促进病毒转阴,具有较好的治疗效果。

Objective To investigate the effect of Bijiajian Pill(鳖甲煎丸)on patients with compensatory chronic hepatitis B(CHB)cirrhosis.Methods A total of 130 patients with compensatory CHB cirrhosis admitted to the hospital from January 2018 to January 2020 were selected as the research subjects,and they were divided into the control group(65 cases)and the observation group(65 cases)by random number table method.The control group was treated with conventional treatment combined with entecavir tablet,and the observation group was treated with Biejiajian Pill on the basis of the control group.Both groups were treated for 24 weeks.The liver function,virology indexes before and after 12 and 24 weeks of treatment,liver hardness,ultrasound imaging indexes,liver fibrosis indexes and levels of serum inflammatory factors before and after 24 weeks of treatment were compared between the two groups.Results After 24 weeks of treatment,the normalization rate of total bilirubin(TBIL),alanine aminotransferase(ALT)/aspartate aminotransferase(AST)and negative rate of hepatitis B virus-deoxy nucleic acid(HBV-DNA)in the observation group were higher than those in the control group(P<0.05).After 24 weeks of treatment,the length of spleen and portal vein diameter in both groups were shorter than those before treatment,and those of the observation group were shorter than those of the control group(P<0.05).Spleen thickness,liver hardness and levels of serum type II procollagen(PC-II),type IV collagen(IV-C),laminin(LN),hyaluronic acid(HA),interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)and hypersensitive C-reactive protein(hs-CRP)were lower than those before treatment,those of the observation group were lower than those of the control group(P<0.05).Conclusion Biejiajian Pill could effectively improve the liver function of patients with compensatory CHB cirrhosis,alleviate the process of liver fibrosis,reduce the inflammatory response of the body,improve the conditions of liver and spleen,promote the virus negative and had a better therapeutic effect.