FibroScan评价复方鳖甲软肝片抗纤维化的疗效

目的使用瞬时弹性威像的方法，评价在恩替卡韦抗病毒治疗基础上，复方鳖甲软肝片治疗代偿期乙型肝炎肝硬化的疗效。方法以代偿期乙型肝炎肝硬化为研究对象，开展前瞻性随机对照试验，对照组50例，使用恩替卡韦抗病毒治疗，试验组50例，在使用恩替卡韦抗病毒基础上联合复方鳖甲软肝片抗纤维化治疗，观察时间节点为6和12个月，比较两组治疗后以及各组自身治疗前后瞬时弹性数值的变化情况。计量资料采用t检验，计数资料及率的比较采用X^2检验。结果复方鳖甲软肝片治疗后，在降低瞬时弹性数值方面，治疗6、12个月均优于对照组（t=2．963、2．239；P=0．004、0．027）。瞬时弹性程度在治疗6、12个月与治疗前比较均有显著下降，对照组治疗6个月与治疗前相比，t=4．295，治疗12个月与治疗前相比，t=6．109，治疗12个月与治疗6个月相比，t=5．394，上述P均〈0．001。试验组治疗6个月与治疗前相比，t=8．505，治疗12个月与治疗前相比，t=9．882，治疗12个月与治疗6个月相比，t=7．930，上述P均〈0．001。治疗12个月后试验组肝硬化的比例明显低于对照组（X^2=4．058，P=0．044）。结论恩替卡韦抗病毒治疗后，肝纤维化的程度可有一定程度的减轻，联合复方鳖甲软肝片治疗后，能够更显著地降低瞬时弹性数值。

EValuation of anti - fibrosis effect of compound Biejia Ruangan tablets with transient elastography

Objective To evaluate the clinical efficacy of compound Biejia Ruangan tablets using transient elastography in patients with hepatitis B-induced compensated liver cirrhosis who are concurrently treated with enteeavir. Methods In this prospective, randomized, and controlled study, 100 patients with hepatitis B-induced compensated liver cirrhosis were randomly assigned to the control group and the experimental group in a ratio of 1：1. The patients in the control group were treated with the anti-virus drug entecavir alone, whereas the patients in the experimental group were treated with entecavir and compound Biejia Ruangan tablets for anti-fibrosis therapy. The patients were followed up at 6 and 12 months. After treatment, the changes in transient elasticity values were evaluated, and the transient elasticity values were compared between the two groups. Continuons variables were compared with the t test and categorical data as well as rates were compared with the chi-square test. Re-suits Treatment with compound Biejia Ruangan tablets led to significantly lower transient elasticity values in the experimental group than in the control group at 6 and 12 months （ t = 2. 963, P = 0. 004 ; t = 2. 239, P = 0. 027）. Transient elasticity values at 6 and 12 months were signifi-cantly lower than their respective baseline levels in the control group （t = 4. 295, P 〈 0. 001 for comparison between values at baseline and 6 months; t = 6. 109, P 〈0. 001 for comparison hetween values at baseline and 12 months; t = 5. 394, P 〈0.001 for comparison between values at 6 and 12 months） and the experimental group （t = 8. 505, P 〈0.001 for comparison between values at baseline and 6 months; t = 9. 882, P 〈0.001 for comparison between values at baseline and 12 months; t = 7. 930, P 〈0. 001 for comparison between values at 6 months and 12 months）. At 12 months, the proportian of patients with liver eirrhosis in the experimental group was significantly lower than that in the control group （X^2 = 4.058, P = 0. 044）. Conclusion Entecavir can relieve liver fibrosis to some extent. Moreover, enteeavir combined with compound Biejia Ruangan tablets can lead to further improvement in liver fibrosis at 6 and 12 months.