恩替卡韦联合扶正化瘀片治疗乙型肝炎肝硬化患者疗效研究

Chinese herbal medicine compound,Fuzheng Huayu table,ameliorate liver fibrosis in patients with hepatitis B-induced liver cirrhosis receiving entecavir antiviral treatment

目的探讨恩替卡韦联合扶正化瘀片治疗乙型肝炎肝硬化患者的疗效。方法2018年8月~2022年12月我院收治的乙型肝炎肝硬化患者122例,被随机分为对照组61例和观察组61例,分别给予恩替卡韦或恩替卡韦联合扶正化瘀片治疗52 w。采用PCR法检测血清HBV DNA载量,采用电化学发光法检测血清HBeAg和HBsAg水平,使用Fibroscan 502型弹性测量仪行肝脏硬度检测(LSM)。结果在治疗52 w末,观察组血清HBV DNA转阴率为96.7%,与对照组的93.4%比,差异无统计学意义(P>0.05),而血清ALT复常率为98.4%,显著高于对照组的85.2%(P<0.05);观察组血清HBsAg和HBeAg水平分别为(826.1±152.6)IU/mL和(194.5±33.8)IU/mL,均显著低于对照组【分别为(1005.3±207.5)IU/mL和(245.6±51.5)IU/mL,P<0.05】;观察组血清ALT、AST和LSM分别为(49.6±7.3)U/L、(39.2±6.1)U/L和(9.2±2.1)kPa,均显著低于对照组【分别为(66.9±10.7)U/L、(52.8±8.7)U/L和(11.8±3.0)kPa,P<0.05】。结论应用恩替卡韦联合扶正化瘀片治疗乙型肝炎肝硬化患者在抗病毒的同时能帮助改善肝功能指标,减轻肝纤维化程度,值得临床进一步研究。

Objective The aim of this study was to investigate the efficacy of Chinese herbal medicine compound,Fuzheng Huayu table,in the treatment of patients with hepatitis B-induced liver cirrhosis(LC)undergoing entecavir treatment.Methods 122 patients with hepatitis B-induced LC were enrolled in our hospital between August 2018 and December 2022,and were randomly divided into control(n=61)and observation(n=61)group,receiving entecavir or entecavir and Fuzheng Huayu table combination therapy for 52 weeks.Serum HBV DNA loads were detected by PCR,serum HBeAg and HBsAg levels were quantitatively assayed electrochemiluminescence,and liver stiffness measurement was determined by Fibroscan 502.Results At the end of 52 week treatment,serum HBV DNA negative rate in the observation group was 96.7%,not significantly different as compared to 93.4%in the control(P>0.05),while serum ALT normalization rate was 98.4%,much higher than 85.2%(P<0.05)in the control;serum HBsAg and HBeAg levels in the combination-treated group were(826.1±152.6)IU/mL and(194.5±33.8)IU/mL,both significantly lower than[(1005.3±207.5)IU/mL and(245.6±51.5)IU/mL,respectively,P<0.05]in the control;serum ALT,AST and the LSM in the observation group were(49.6±7.3)U/L,(39.2±6.1)U/L and(9.2±2.1)kPa,all significantly lower than[(66.9±10.7)U/L,(52.8±8.7)U/L and(11.8±3.0)kPa,respectively,P<0.05]in the control group.Conclusion The auxiliary oral administration of Fuzheng Huayu capsule at base of entecavir antiviral therapy might ameliorate liver fibrosis in patients with hepatitis B-induced LC,and is worthy of further clinical investigation.