恩替卡韦联合扶正化瘀胶囊治疗代偿期乙型肝炎肝硬化的效果及其对肝功能、血清肝纤维化指标的影响
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摘要
目的分析恩替卡韦联合扶正化瘀胶囊治疗代偿期乙型肝炎肝硬化对肝功能水平、血清肝纤维化指标的影响。方法选择我院2016年1月至2017年12月收治的100例代偿期乙型肝炎肝硬化患者,按随机数字表法将其分为对照组(50例,采用恩替卡韦治疗)与观察组(50例,恩替卡韦联合扶正化瘀胶囊进行治疗)。比较两组患者的血清肝纤维化指标水平、肝功能、炎症因子水平、HBV-DNA转阴率、ALT复常率及不良反应发生率。结果治疗前,两组患者的CⅣ、PCⅢ、LN、HA、AST、ALT、hs-CRP、IL-8、IL-6、TNF-α水平比较,差异均无统计学意义(P>0.05);治疗后,两组患者的上述指标水平均降低,且观察组低于对照组,差异具有统计学意义(P<0.05)。观察组患者的HBV-DNA转阴率、ALT复常率高于对照组(P<0.05)。观察组的不良反应总发生率略低于对照组(P>0.05)。结论恩替卡韦与扶正化瘀胶囊联合可有效改善代偿期乙型肝炎肝硬化患者肝功能,减轻炎症反应,提高HBV-DNA转阴率,效果显著,值得借鉴。
Objective To analyze the effect of entecavir combined with Fuzheng Huayu capsule in compensatory hepatitis B cirrhosis and the influence on liver function and serum hepatic fibrosis indicators. Methods A total of 100 patients with compensatory hepatitis B cirrhosis admitted to our hospital from January 2016 to December 2017 were selected and randomly divided into control group(50 cases, treated with entecavir) and observation group(50 cases, treated with entecavir combined with Fuzheng Huayu capsule). The levels of serum liver fibrosis indexes, liver function and inflammatory factors, HBV-DNA negative conversion rates, ALT normalization rates and incidences of adverse reactions between the two groups were compared. Results Before treatment, there were no significant differences in the levels of CIV, PC Ⅲ, LN, HA, AST, ALT,hs-CRP, IL-8, IL-6 and TNF-α between the two groups(P >0.05); after treatment, the above indicators in both groups decreased, and those in the observation group were lower than the control group, the differences were statistically significant(P <0.05). The HBV-DNA negative conversion rate and ALT normalization rate of the observation group were higher than those of the control group(P<0.05). The total incidence of adverse reactions in the observation group was silightly lower than that of the control group(P>0.05). Conclusion Entecavir combined with Fuzheng Huayu capsule can effectively improve liver function of patients with compensatory hepatitis B cirrhosis, alleviate the inflammatory response and improve the HBV-DNA negative conversion rate, with significant effect, which is worthy of learning.
Objective To analyze the effect of entecavir combined with Fuzheng Huayu capsule in compensatory hepatitis B cirrhosis and the influence on liver function and serum hepatic fibrosis indicators. Methods A total of 100 patients with compensatory hepatitis B cirrhosis admitted to our hospital from January 2016 to December 2017 were selected and randomly divided into control group(50 cases, treated with entecavir) and observation group(50 cases, treated with entecavir combined with Fuzheng Huayu capsule). The levels of serum liver fibrosis indexes, liver function and inflammatory factors, HBV-DNA negative conversion rates, ALT normalization rates and incidences of adverse reactions between the two groups were compared. Results Before treatment, there were no significant differences in the levels of CIV, PC Ⅲ, LN, HA, AST, ALT,hs-CRP, IL-8, IL-6 and TNF-α between the two groups(P >0.05); after treatment, the above indicators in both groups decreased, and those in the observation group were lower than the control group, the differences were statistically significant(P <0.05). The HBV-DNA negative conversion rate and ALT normalization rate of the observation group were higher than those of the control group(P<0.05). The total incidence of adverse reactions in the observation group was silightly lower than that of the control group(P>0.05). Conclusion Entecavir combined with Fuzheng Huayu capsule can effectively improve liver function of patients with compensatory hepatitis B cirrhosis, alleviate the inflammatory response and improve the HBV-DNA negative conversion rate, with significant effect, which is worthy of learning.
引文
[1]张雷鸣,张庆丽.恩替卡韦联合扶正化瘀胶囊治疗失代偿期乙型肝炎肝硬化的临床疗效及安全性[J].临床合理用药杂志,2017,10(33):7-8,11.
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[10]李国焕,舒盼,张均倡,等.恩替卡韦联合扶正化瘀胶囊治疗乙型肝炎肝硬化疗效观察[J].中西医结合肝病杂志,2015,25(4):217-219.
[11]洪仲思,陈奕伸,刘健,等.扶正化瘀胶囊治疗乙肝肝硬化脾功能亢进及抗肝纤维化疗效观察[J].中药材,2014,37(6):1103-1106.
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[13]吴眉,徐列明.扶正化瘀胶囊对抗病毒有效的乙型肝炎肝硬化患者外周血细胞因子的调节[J].肝脏,2017,22(12):1094-1097.
[14]张红星,刘旭东,吴辉坤.扶正化瘀胶囊对慢性乙型肝炎肝硬化患者炎性因子的影响[J].中西医结合肝病杂志,2016,26(1):4-5.
[15]吕耀青.恩替卡韦联合扶正化瘀胶囊治疗失代偿期乙型肝炎肝硬化的临床效果[J].临床医学研究与实践,2017,2(7):60-61.
[2]杨智娟.恩替卡韦联合扶正化瘀胶囊治疗乙肝肝硬化失代偿期的临床观察[J].当代医学,2015,21(17):132-133.
[3]王贺,王千钧,孙风波,等.恩替卡韦联合扶正化瘀胶囊对代偿期慢性乙型肝炎肝硬化患者炎性因子及纤维化指标的影响[J].临床肝胆病杂志,2016,32(9):1734-1738.
[4]王守兵,刘星,孟召刚.扶正化瘀胶囊联合恩替卡韦分散片治疗乙型肝炎肝硬化32例疗效观察[J].肝脏,2016,21(1):77-78.
[5]李黎,崔富强,张国民,等.乙型肝炎诊断标准(WS299-2008)解读[J].中华预防医学杂志,2014,48(9):758-761.
[6]朱文锋.中医诊断与鉴别诊断学[M].北京:人民卫生出版社,2001.
[7]杨妍,锁忠岐.恩替卡韦联合扶正化瘀胶囊对代偿期慢性乙型肝炎肝硬化患者炎性因子及纤维化指标的影响[J].中国生化药物杂志,2017,37(10):40-41.
[8]HUNG HF,WANG YC,YEN MF,et al.Stochastic model for hepatitis B virus infection through maternal(vertical)and environmental(horizontal)transmission with applications to basic reproductive number estimation and economic appraisal of preventive strategies[J].Stoch Environ Res Risk Assess,2014,28(3):611-625.
[9]郝瑞军.恩替卡韦联合扶正化瘀胶囊治疗乙型肝炎后肝硬化失代偿期疗效观察[J].中国药物与临床,2017,17(10):1507-1509.
[10]李国焕,舒盼,张均倡,等.恩替卡韦联合扶正化瘀胶囊治疗乙型肝炎肝硬化疗效观察[J].中西医结合肝病杂志,2015,25(4):217-219.
[11]洪仲思,陈奕伸,刘健,等.扶正化瘀胶囊治疗乙肝肝硬化脾功能亢进及抗肝纤维化疗效观察[J].中药材,2014,37(6):1103-1106.
[12]LAMPERTICO P,INVERNIZZI F,VIGAN魹M,et al.The long-term benefits of nucleos(t)ide analogs in compensated HBV cirrhotic patients with no or small esophageal varices:a 12-year prospective cohort study[J].J Hepatol,2015,63(5):1118-1125.
[13]吴眉,徐列明.扶正化瘀胶囊对抗病毒有效的乙型肝炎肝硬化患者外周血细胞因子的调节[J].肝脏,2017,22(12):1094-1097.
[14]张红星,刘旭东,吴辉坤.扶正化瘀胶囊对慢性乙型肝炎肝硬化患者炎性因子的影响[J].中西医结合肝病杂志,2016,26(1):4-5.
[15]吕耀青.恩替卡韦联合扶正化瘀胶囊治疗失代偿期乙型肝炎肝硬化的临床效果[J].临床医学研究与实践,2017,2(7):60-61.