恩替卡韦联合复方鳖甲软肝片在慢性乙型肝炎肝硬化患者中的治疗效果

Therapeutic Effect of Entecavir Combined with Fufang Biejia Ruangan Tablets on Patients with Cirrhosis in Chronic Hepatitis B

目的:观察恩替卡韦联合复方鳖甲软肝片在慢性乙型肝炎(CHB)肝硬化患者中的治疗效果。方法:选取2020年1月—2023年6月上饶市第二人民医院收治的84例CHB肝硬化患者,按随机数字表法分为联合组(n=43)、对照组(n=41)。对照组使用恩替卡韦治疗,联合组于对照组基础上加用复方鳖甲软肝片治疗。比较两组治疗前后肝功能指标[总胆红素(TBIL)、谷草转氨酶(AST)及谷丙转氨酶(ALT)]、免疫指标[辅助性T细胞17(Th17)、调节性T细胞(Treg)、Th17/Treg]、炎症因子[白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)]、肝纤维化指标[透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PCⅢ)及Ⅳ型胶原(Ⅳ-C)]及药物不良反应发生率。结果:治疗后,联合组TBIL、AST及ALT水平均低于对照组,差异均有统计学意义(P<0.05);治疗后,联合组Th17、Th17/Treg均低于对照组,Treg高于对照组,差异均有统计学意义(P<0.05);治疗后,联合组IL-1β、IL-6及TNF-α水平均低于对照组,差异均有统计学意义(P<0.05);治疗后,联合组HA、LN、PCⅢ及Ⅳ-C水平均低于对照组,差异均有统计学意义(P<0.05)。两组药物不良反应发生率比较,差异无统计学意义(P>0.05)。结论:恩替卡韦联合复方鳖甲软肝片能够有效改善CHB肝硬化患者免疫状态,减轻炎症反应及肝纤维化,提高肝功能。

Objective:To observe the therapeutic effect of Entecavir combined with Fufang Biejia Ruangan Tablets on patients with chronic hepatitis B(CHB)and cirrhosis.Method:A total of 84 patients with CHB and cirrhosis who were admitted to Shangrao Second People's Hospital from January 2020 to June 2023 were selected,and they were divided into combination group(n=43)and control group(n=41)according to random number table method.The control group was treated with Entecavir,and the combination group was treated with Fufang Biejia Ruangan Tablets on the basis of the control group.Liver function indexes[total bilirubin(TBIL),aspartate aminotransferase(AST)and alanine aminotransferase(ALT)],immune indexes[helper T cells 17(Th17),regulatory T cells(Treg)and Th17/Treg],inflammatory factors[interleukin-1β(IL-1β),interleukin-6(IL-6)and tumor necrosis factors-α(TNF-α)],liver fibrosis indexes[hyaluronic acid(HA),laminin(LN),typeⅢprocollagen(PCⅢ)and typeⅣcollagen(Ⅳ-C)]before and after treatment and incidence of adverse drug reactions between the two groups were compared.Result:After treatment,the levels of TBIL,AST and ALT in combination group were lower than those in control group,the differences were statistically significant(P<0.05).After treatment,Th17 and Th17/Treg in combination group were lower than those in control group,and Treg was higher than that in the control group,the differences were statistically significant(P<0.05).After treatment,the levels of IL-1β,IL-6 and TNF-αin combination group were lower than those in control group,the differences were statistically significant(P<0.05).After treatment,the levels of HA,LN,PCⅢandⅣ-C in combination group were lower than those in control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse drug reactions between the two groups(P>0.05).Conclusion:Entecavir combined with Fufang Biejia Ruangan Tablets can effectively improve the immune state,reduce inflammation and liver fibrosis in patients with CHB and cirrhosis,and improve liver function.