扶正化瘀胶囊联合恩替卡韦治疗慢性乙型肝炎肝纤维化的效果观察

Curative effects of Fuzheng Huayu capsule combined with entecavir on chronic hepatitis B liver fibrosis

目的探讨扶正化瘀胶囊联合恩替卡韦对慢性乙型肝炎(CHB)肝纤维化患者丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)的影响。方法抽取商丘市中医院2020年5月至2022年4月收治的CHB肝纤维化患者88例,采用随机数字法分为单一组(44例)和联合组(44例)。单一组采用恩替卡韦治疗,联合组在单一组治疗基础上采用扶正化瘀胶囊治疗。比较两组疗效,比较两组治疗前后炎症因子[白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、超敏C反应蛋白(hs-CRP)]、肝功能[ALT、TBIL、天门冬氨酸氨基转移酶(AST)]、肝纤维化指标[透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PC Ⅲ)]水平,比较两组不良反应发生率。结果联合组总有效率(97.73%,43/44)高于单一组(81.82%,36/44),P<0.05;治疗后,联合组IL-6、IL-8、hs-CRP水平低于单一组(P<0.05),ALT、TBIL、AST、HA、LN、PC Ⅲ水平亦低于对照组(P<0.05)。联合组不良反应发生率(4.55%,2/44)低于单一组(20.45%,9/44),P<0.05。结论扶正化瘀胶囊联合恩替卡韦治疗CHB肝纤维化疗效较好,能降低多种炎症因子水平,改善患者肝功能,且治疗安全性良好。

Objective To investigate the effect of Fuzheng Huayu capsule combined with entecavir on glutamic pyruvic transaminase(ALT)and total bilirubin(TBIL)in patients with chronic hepatitis B(CHB)liver fibrosis.Methods A total of 88 patients with CHB and liver fibrosis treated in Shangqiu Hospital of Traditional Chinese Medicine from May 2020 to April 2022 were selected,and they were divided into single group(44 case)and combined group(44 cases)by random number table method.The single group was treated with entecavir,and the combined group was treated with Fuzheng Huayu capsule based the treatment of the single group.The curative effect of the two group were compared.The preoperative and postoperative levels of inflammatory factors,including interleukin-6(IL-6),interleukin-8(IL-8)and hypersensitive C-reactive protein(hs-CRP),liver function assessed by ALT,TBIL and glutamic oxaloacetic transaminase(AST),liver fibrosis indexes,including hyaluronic acid(HA),laminin(LN)and procollagen typeⅢ(PCⅢ),and the incidence of adverse reactions were compared between the two groups.Results The total effective rate of the combined group was 97.73%(43/44),which was higher than the 81.82%(36/44)of the single group(P<0.05).After treatment,the levels of IL-6,IL-8 and hs-CRP in the combined group were lower than those in the single group(P<0.05),the levels of ALT,TBIL and AST in the combined group were lower than those in the single group(P<0.05),the levels of HA,LN and PCⅢin the combined group were lower than those in the single group(P<0.05).The incidence of adverse reactions in the combined group was 4.55%(2/44),which was lower than 20.45%(9/44)in the single group(P<0.05).Conclusions Fuzheng Huayu capsule combined with entecavir is effective in the treatment of CHB with liver fibrosis,which can reduce the levels of various inflammatory factors,improve liver function,and has good safety.