滋阴活血汤恩替卡韦治疗代偿期乙型肝炎肝硬化的临床效果

目的 探讨滋阴活血汤、恩替卡韦治疗代偿期乙型肝炎肝硬化的临床效果.方法 收集2012年1月至2014年1月胶州市人民医院收治的代偿期乙型肝炎肝硬化患者98例,按照随机数字表法分为对照组与治疗组,各49例.对照组在对症支持治疗的基础上采用西药恩替卡韦治疗,治疗组在对症支持治疗的基础上采用滋阴活血汤联合恩替卡韦治疗.3个月为1个疗程,两组均治疗3个疗程后,追踪随访入选患者,比较两组肝纤维化指标、乙肝病毒标志物情况以及肝功能指标变化.结果 治疗组ALT复常率分别为73.5％、83.7％、89.8％和91.8％,均显著高于对照组,差异有统计学意义(均P＜0.05);治疗组HBV DNA转阴率分别为73.5％、79.6％、85.7％和91.8％,均显著高于对照组,差异有统计学意义(均P＜ 0.05);治疗组总有效率(显效率+有效率)为95.9％,显著高于对照组的59.2％,差异有统计学意义(P＜0.05);治疗组显效率显著高于对照组(73.5％比26.5％),差异有统计学意义(P＜0.05);治疗组HA、Ⅲ型前胶原和Ⅳ型胶原指标均优于对照组,差异有统计学意义(均P＜ 0.05).结论 滋阴活血汤、恩替卡韦治疗代偿期乙型肝炎肝硬化可以明显改善患者临床症状,提高临床疗效,安全可靠,值得临床推广.

Ziyin Huoxue decoction and entecavir in treatment of decompensated hepatitis B cirrhosis

Objective To investigate the therapeutic effect of Ziyin Huoxue decoction and entecavir in the treatment of decompensated hepatitis B cirrhosis.Methods 98 cases of chronic hepatitis B cirrhosis treated at our hospital from January,2012 to January,2014 were randomly divided into a control group and a treatment group,49 cases for each group.The control group was given symptomatic support treatment and took entecavir;in addition,the treatment group was treated with Ziyin Huoxue decoction.3 months was 1 treatment course.Both groups were treated 3 courses.The patients were followed up.The liver fibrosis indicators,hepatitis B virus markers,and liver function indicators were compared between these two groups.Results The ALT recovery rates were 73.5％,83.7％,89.8％,and 91.8％ in the treatment group,which were significantly higher than those in the control group,with statistical differences (all P ＜ 0.05).The HBV DNA negative rates were 73.5％,79.6％,85.7％,and 91.8％ in the treatment group,which were significantly higher than those in the control group,with statistical differences (all P ＜ 0.05).The total efficacy was 95.9％ in the treatment group and 59.2％ in the control group,with a statistical difference (P ＜ 0.05).The obviously effective rate was 73.5％ in the treatment group and 26.5％ in the control group,with a statistical difference (P ＜ 0.05).The HA,procollagen type Ⅲ,and type Ⅳcollagen were better in the treatment group than in the control group,with statitical differences (all P ＜ 0.05).Conclusions Ziyin Huoxue decoction and entecavir in the treatment of decompensated hepatitis B cirrhosis can significantly improve the patients' clinical symptoms and improve clinical curative effect and is safe and reliable,so it is worth being clinically generalized.