六味五灵片联合复方甘草酸苷治疗活动性慢性乙型肝炎肝硬化的疗效观察

目的探讨六味五灵片联合复方甘草酸苷治疗活动性慢性乙型肝炎肝硬化的临床疗效。方法选取2015年2月—2016年2月在驻马店市中心医院接受治疗的78例活动性慢性乙型肝炎肝硬化患者为研究对象,根据治疗方案的差别分为对照组(39例)和治疗组(39例)。对照组患者口服复方甘草酸苷片,75 mg/次,3次/d。治疗组在对照组的基础上口服六味五灵片,1.5 g/次,3次/d。两组患者均经过48周治疗。评价两组患者临床疗效,同时比较治疗前后两组患者HBV-DNA和乙型肝炎E抗原(HBe Ag)转阴率、肝功能、肝纤维化指标以及肝硬度和Child-Pugh评分。结果治疗后,对照组和治疗组的总有效率分别为79.49%和94.87%,两组比较差异具有统计学意义(P0.05)。治疗24、48周后,治疗组中HBV-DNA和HBe Ag转阴率均分别高于同期对照组患者,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者肝功能血清丙氨酸氨基转移酶(ALT)、门冬氨酸转氨酶(AST)、总胆红素(TBIL)均显著降低,白蛋白(ALB)明显升高,同组比较差异具有统计学意义(P0.05);且治疗组患者肝功能显著优于对照组(P0.05)。治疗后,两组患者血清透明质酸(HA)、层黏连蛋白(LN)、Ⅲ型前胶原肽(PC-Ⅲ)、Ⅳ型胶原(Ⅳ-C)均明显降低(P0.05);且治疗组上述肝纤维化指标显著低于对照组患者(P0.05)。治疗后,两组患者肝硬度和Child-Pugh评分均明显降低(P0.05);且治疗组患者肝硬度和Child-Pugh评分明显低于对照组患者(P0.05)。结论六味五灵片联合复方甘草酸苷治疗活动性慢性乙型肝炎肝硬化可有效改善患者肝功能和肝纤维化指标,具有一定的临床推广应用价值。

Clinical observation of Liuwei Wuling Tablets combined with compound glycyrrhizin in treatment of active chronic hepatitis B cirrhosis

Objective To investigate the clinical efficacy of Liuwei Wuling Tablets combined with compound glycyrrhizin in treatment of active chronic hepatitis B cirrhosis. Methods Patients (78 cases) with active chronic hepatitis B cirrhosis in Zhumadian Central Hospital from February 2015 to February 2016 were divided into control (39 cases) and treatment (39 cases) groups according to different treatments.Patients in the control group were po administered with Compound Glycyrrhizin Tablets,75 mg/time,three times daily.Patients in the treatment group were po administered with Liuwei Wuling Tablets on the basis of the control group,1.5 g/time, three times daily. Patients in two groups were treated for 48 weeks. After treatment, the clinical efficacy was evaluated, and HBV-DNA and HBeAg negative rate, liver function, liver fibrosis indexes, liver cirrhosis and Child-Pugh scores in two groups before and after treatment was compared. Results After treatment, the clinical efficacy in the control and treatment groups were 79.49% and 94.87%, respectively, and there were differences between two groups (P < 0.05). After treatment for 24 and 48 weeks, the HBV-DNA and HBeAg negative rate in the treatment group were higher than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the ALT, AST and TBIL level in two groups was significantly decreased, but ALB was significantly increased, and the difference was statistically significant in the same group (P < 0.05). The liver function in the treatment group was significantly better than that in the control group (P < 0.05). After treatment, the serum HA, LN, PC-Ⅲ, and Ⅳ-C level in two groups was significantly decreased (P < 0.05), and the liver fibrosis indexes in the treatment group were significantly lower than that in the control group (P < 0.05). After treatment, the liver stiffness and Child-Pugh scores in two groups were significantly decreased (P < 0.05), and the liver cirrhosis and Child-Pugh scores in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Liuwei Wuling Tablets combined with compound glycyrrhizin can effectively improve the liver function and liver fibrosis indexes in treatment of active chronic hepatitis B cirrhosis, which has a certain clinical application value.