复方鳖甲软肝片联合恩替卡韦治疗慢性乙型肝炎患者的效果

Effects of compound Biejia Ruangan tablets combined with Entecavir in treatment of patients with chronic hepatitis B

目的:观察复方鳖甲软肝片联合恩替卡韦治疗慢性乙型肝炎(CHB)患者的效果。方法:选取2021年4月至2023年4月该院收治的110例CHB患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各55例。两组均予以基础治疗,在此基础上,对照组予以恩替卡韦治疗,观察组在对照组基础上联合复方鳖甲软肝片治疗,两组均持续治疗6个月。比较两组临床疗效,治疗前后中医证候积分和炎性因子[白细胞介素-6(IL-6)、γ干扰素(IFN-γ)、超敏C反应蛋白(hs-CRP)]、肝纤维化指标[层粘连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)、透明质酸(HA)]、肝功能指标[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)]水平,以及不良反应发生率。结果:观察组治疗总有效率为92.73%(51/55),高于对照组的78.18%(43/55),差异有统计学意义(P<0.05);治疗后,观察组两肋刺痛、肋下痞块、面色晦暗、红丝赤缕等中医证候积分均低于对照组,差异有统计学意义(P<0.05);治疗后,观察组IL-6、IFN-γ、hs-CRP水平均低于对照组,差异有统计学意义(P<0.05);治疗后,观察组LN、PCⅢ、Ⅳ-C、HA水平均低于对照组,差异有统计学意义(P<0.05);治疗后,观察组ALT、AST、TBIL水平均低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:复方鳖甲软肝片联合恩替卡韦治疗CHB患者可提高治疗总有效率,降低中医证候积分和炎性因子、肝纤维化指标、肝功能指标水平,效果优于单纯恩替卡韦治疗。

Objective:To observe effects of compound Biejia Ruangan tablets combined with Entecavir in treatment of patients with chronic hepatitis B(CHB).Methods:A prospective study was conducted on 110 patients with CHB admitted to the hospital from April 2021 to April 2023.According to the random number table method,they were divided into control group and observation group,55 cases in each group.Both groups were given basic treatment.On this basis,the control group was treated with Entecavir,while the observation group was treated with compound Biejia Ruangan tablets on the basis of that of the control group.Both groups were treated for 6 months.The clinical efficacy,the TCM syndrome scores and the levels of the inflammatory factors[interleukin-6(IL-6),interferon-γ(IFN-γ),high-sensitivity C-reactive protein(hs-CRP)],the liver fibrosis indexes[laminin(LN),type III procollagen(PCIII),type IV collagen(IV-C),hyaluronic acid(HA)]and the liver function indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL)]before and after the treatment,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 92.73%(51/55),which was higher than 78.18%(43/55)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the scores of TCM syndromes such as two-rib tingling,subcostal mass,dull complexion and red threads in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of IL-6,IFN-γand hs-CRP in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of LN,PCIII,IV-C and HA in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of ALT,AST and TBIL in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Compound Biejia Ruangan tablets combined with Entecavir in the treatment of the CHB patients can improve the total effective rate of treatment,reduce the scores of TCM syndromes and the levels of inflammatory factors,liver fibrosis indexes and liver function indexes.Moreover,it is superior to simple Entecavir treatment.