血府逐瘀汤加减联合恩替卡韦对乙肝肝硬化失代偿期肝纤维化的影响

Effect of Xuefu Zhuyu Decoction combined with entecavir on liver fibrosis in decompensated stage of hepatitis B cirrhosis

目的探讨血府逐瘀汤加减联合恩替卡韦对乙肝肝硬化失代偿期肝纤维化的影响。方法选取2020年6月至2021年12月在该院就诊的80例乙肝肝硬化失代偿期患者作为研究对象,采用随机分组的方式分为对照组和研究组,每组各40例。对照组采用恩替卡韦治疗,研究组采用血府逐瘀汤加减联合恩替卡韦治疗,分析两组患者肝纤维化指标、中医症状评分、炎症因子、肝功能、乙肝病毒基因及乙肝表面抗原转阴率,统计两组患者的疗效。结果两组患者治疗后层粘连蛋白、Ⅳ型胶原、Ⅲ型前胶原、透明质酸酶、白细胞介素(IL)-6、IL-8、肿瘤坏死因子-α、丙氨酸氨基转移酶、总胆红素水平,以及中医症状积分均低于治疗前,且研究组低于对照组,差异均有统计学意义(P<0.05)。两组患者治疗后清蛋白水平高于治疗前,且研究组高于对照组,差异均有统计学意义(P<0.05)。两组患者治疗后门静脉内径、脾厚度均小于治疗前,且研究组小于对照组,差异均有统计学意义(P<0.05)。研究组患者总有效率明显高于对照组,差异有统计学意义(P<0.05)。结论血府逐瘀汤加减联合恩替卡韦治疗乙肝肝硬化失代偿期患者可有效改善其肝纤维化,保护肝功能,疗效较好。

Objective To explore the effect of combined application of Xuefu Zhuyu Decoction and entecavir on liver fibrosis in patients with decompensated hepatitis B cirrhosis.Methods Eighty patients with decompensated cirrhosis of hepatitis B were enrolled and treated in our hospital from June 2020 to December 2021.They were randomly divided into control group and research group,with 40 patients in each group.The control group was treated with entecavir,and the research group was treated with Xuefu Zhuyu Decoction combined with entecavir.The liver fibrosis line indicators,Traditional Chinese Medicine(TCM)symptom scores,inflammatory factors,liver function,hepatitis B virus gene(HBV DNA)and hepatitis B surface antigen(HBeAg)negative conversion rate of the two groups were analyzed,and the treatment effects of the two groups were statistically analyzed.Results After treatment,laminin(LN),typeⅣcollagen(Ⅳ-C),typeⅢprocollagen(PC-Ⅲ),hyaluronidase(HA),interleukin-6(IL-6),interleukin-8(IL-8),and tumor necrosis factor-α(TNF-α)alanine aminotransferase and total bilirubin and TCM symptom score were lower than before treatment,and the research group was significantly lower than the control group(P<0.05).After treatment,the diameter of portal vein and the thickness of spleen in the two groups decreased,and compared with the control group,the diameter of portal vein and the thickness of spleen in the research group were significantly thinner(P<0.05),which of the research group was significantly lower than the control group(P<0.05).The total effective rate in the research group was significantly higher than that in the control group(P<0.05).Conclusion The combination of Xuefu Zhuyu Decoction and entecavir in the treatment of patients with decompensated hepatitis B cirrhosis can effectively improve liver fibrosis and protect liver function,with good effect.