鳖甲煎丸联合恩替卡韦治疗乙肝肝纤维化临床观察
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摘要
目的:研究鳖甲煎丸联合恩替卡韦治疗乙肝肝纤维化的临床疗效。方法:将符合纳入标准的120例慢性乙肝肝纤维化患者随机分治疗组和对照组,每组60例。两组均给予恩替卡韦分散片抗病毒治疗,治疗组加用鳖甲煎丸,疗程24周。观察两组患者治疗前后的生化功能、HBV-DNA水平、HBeAg水平、FibroScan中的CAP值。结果:两组患者治疗后ALT水平、ALB水平、TBIL水平均较治疗前有所改善,差异有统计学意义(P <0. 05),且治疗后ALP水平治疗组优于对照组,差异有统计学意义(P <0. 05)。两组患者治疗后HBV-DNA水平均较治疗前改善,差异有统计学意义(P <0. 05)。两组的CAP值均在治疗后较治疗前有改善,差异具有统计学意义(P <0. 05),同时治疗组在经过治疗后优于对照组,差异具有统计学意义(P <0. 05)。结论:复方中成药鳖甲煎丸联合恩替卡韦分散片治疗慢性乙肝肝纤维化的中西医结合疗法,能够有效改善慢性乙肝患者的肝纤维化,同时也具有一定的改善肝细胞炎症的作用。
Objective: To study the clinical efficacy of Biejia Jian Pill combined with Entecavir in the treatment of liver fibrosis of hepatitis B. Methods: 120 cases of liver fibrosis of chronic hepatitis B were randomly divided into the observation group(n = 60) and the control group(n = 60). The control group was treated with Entecavir Dispersible Tablets; on which basis,the observation group was also treated with Beijia Jian Pill.The treatment duration was 24 weeks. The biochemical function,HBV-DNA level,HBeAg level and CAP value in FibroScan were observed before and after the treatment in the two groups. Results: The levels of ALT,ALB and TBIL were improved after the treatment compared to those before the treatment in the two groups(P < 0. 05); of which the observation group was superior to the control group in the improvement of ALT level(P < 0. 05). The levels of HBV-DNA and CAP value were improved after the treatment in the two groups(P < 0. 05); of which the improvements were more significant in the observation group than those in the control group(P < 0. 05). Conclusion: Biejia Jian Pill combined with Entecavir can effectively alleviate the degree of liver fibrosis in patients with chronic hepatitis B,and it has a certain role in improving hepatocyte inflammation.
Objective: To study the clinical efficacy of Biejia Jian Pill combined with Entecavir in the treatment of liver fibrosis of hepatitis B. Methods: 120 cases of liver fibrosis of chronic hepatitis B were randomly divided into the observation group(n = 60) and the control group(n = 60). The control group was treated with Entecavir Dispersible Tablets; on which basis,the observation group was also treated with Beijia Jian Pill.The treatment duration was 24 weeks. The biochemical function,HBV-DNA level,HBeAg level and CAP value in FibroScan were observed before and after the treatment in the two groups. Results: The levels of ALT,ALB and TBIL were improved after the treatment compared to those before the treatment in the two groups(P < 0. 05); of which the observation group was superior to the control group in the improvement of ALT level(P < 0. 05). The levels of HBV-DNA and CAP value were improved after the treatment in the two groups(P < 0. 05); of which the improvements were more significant in the observation group than those in the control group(P < 0. 05). Conclusion: Biejia Jian Pill combined with Entecavir can effectively alleviate the degree of liver fibrosis in patients with chronic hepatitis B,and it has a certain role in improving hepatocyte inflammation.
引文
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[6]刘翔,顾丰华,陈嘉,等.鳖甲煎丸对ConA诱导小鼠肝炎和肝纤维化的治疗作用[J].中成药,2013,35(10):2088-2093.
[7]关华,刘玉萍,李明非,等.鳖甲煎丸联合恩替卡韦治疗乙肝肝硬化代偿期的效果观察[J].中药药理与临床,2017,33(1):194-196.
[8]唐承璐,吕小红,韩菊平,等.鳖甲煎丸对慢性乙肝合并肝硬化患者炎症因子及肝纤维化指标的影响[J].海南医学院学报,2018,24(15):1410-1413.
[9] HUANG R,JIANG N,YANG R,et al. Fibroscan improves the diagnosis sensitivity of liver fibrosis in patients with chronic hepatitis B[J].Experimental&Therapeutic Medicine,2016,11(5):1673-1677.
[10]王春颖,王骥,贾炳文,等. FibroScan对慢性乙型肝炎肝纤维化诊断的临床价值[J].传染病信息,2014,27(4):226-228.
[11]刘雪芹,骆雁翎,张迎春,等.超声弹性成像与弥散定量分析评估肝纤维化程度[J].现代仪器与医疗,2018,24(1):10-12.
[12]熊慧,毛龙细,熊小蔚,等.有创性与无创性检测肝纤维化分期对比研究[J].中国医学创新,2018,15(31):5-8.
[13]孙妩弋,魏伟.中药和天然药物治疗肝纤维化的研究[J].中国药理学通报,2004,20(7):741-745.
[14]蔡纲,李绍民.翻白草对CCL4所致慢性肝损伤大鼠肝脏保护作用的实验研究[J].中医药信息,2017,34(1):13-16.
[15]李滨,张佳圆,王凤永,等.胆宁片治疗非酒精性脂肪肝临床效果及对血脂、肝功能和肝纤维化的影响[J].解放军医药杂志,2018,30(10):93-96.
[16]刘旺华,袁建,文生.中药复方防治肝纤维化的研究进展[J].黑龙江中医药,2010,39(5):55-56.
[17]张弘,陶森,郝彧,等.国外肝纤维化诊断的研究热点分析[J].首都医科大学学报,2016,37(1):83-88.
[18]肝脏硬度评估小组.瞬时弹性成像技术诊断肝纤维化专家意见[J].中华肝脏病杂志,2013,21(6):420-423.
[2]王鹿,李丽萍,邢欣,等.肝脏巨噬细胞及其在肝损伤和修复中的作用[J].中国临床药理学与治疗学,2018,23(10):1188-1195.
[3]张玉昆,冯月男,卞敬琦,等.龙牙肝泰胶囊抗肝纤维化的药效学研究[J].中医药信息,2018,35(4):52-55.
[4] ISSA R,ZHOU X,CONSTANDINOU C M,et al. Spontaneous recovery from micronodular cirrhosis:evidence for incomplete resolution associated with matrix cross-linking[J]. Gastroenterology,2004,126(7):1795-1808.
[5]孙玉凤,李媛,李风华,等.鳖甲煎丸对肝纤维化大鼠TGF-β1/samd信号通路的影响[J].中草药,2013,44(23):3364-3367.
[6]刘翔,顾丰华,陈嘉,等.鳖甲煎丸对ConA诱导小鼠肝炎和肝纤维化的治疗作用[J].中成药,2013,35(10):2088-2093.
[7]关华,刘玉萍,李明非,等.鳖甲煎丸联合恩替卡韦治疗乙肝肝硬化代偿期的效果观察[J].中药药理与临床,2017,33(1):194-196.
[8]唐承璐,吕小红,韩菊平,等.鳖甲煎丸对慢性乙肝合并肝硬化患者炎症因子及肝纤维化指标的影响[J].海南医学院学报,2018,24(15):1410-1413.
[9] HUANG R,JIANG N,YANG R,et al. Fibroscan improves the diagnosis sensitivity of liver fibrosis in patients with chronic hepatitis B[J].Experimental&Therapeutic Medicine,2016,11(5):1673-1677.
[10]王春颖,王骥,贾炳文,等. FibroScan对慢性乙型肝炎肝纤维化诊断的临床价值[J].传染病信息,2014,27(4):226-228.
[11]刘雪芹,骆雁翎,张迎春,等.超声弹性成像与弥散定量分析评估肝纤维化程度[J].现代仪器与医疗,2018,24(1):10-12.
[12]熊慧,毛龙细,熊小蔚,等.有创性与无创性检测肝纤维化分期对比研究[J].中国医学创新,2018,15(31):5-8.
[13]孙妩弋,魏伟.中药和天然药物治疗肝纤维化的研究[J].中国药理学通报,2004,20(7):741-745.
[14]蔡纲,李绍民.翻白草对CCL4所致慢性肝损伤大鼠肝脏保护作用的实验研究[J].中医药信息,2017,34(1):13-16.
[15]李滨,张佳圆,王凤永,等.胆宁片治疗非酒精性脂肪肝临床效果及对血脂、肝功能和肝纤维化的影响[J].解放军医药杂志,2018,30(10):93-96.
[16]刘旺华,袁建,文生.中药复方防治肝纤维化的研究进展[J].黑龙江中医药,2010,39(5):55-56.
[17]张弘,陶森,郝彧,等.国外肝纤维化诊断的研究热点分析[J].首都医科大学学报,2016,37(1):83-88.
[18]肝脏硬度评估小组.瞬时弹性成像技术诊断肝纤维化专家意见[J].中华肝脏病杂志,2013,21(6):420-423.