养血柔肝汤联合恩替卡韦治疗慢性乙型病毒性肝炎肝纤维化

目的:观察养血柔肝汤联合恩替卡韦治疗慢性乙型病毒性肝炎肝纤维化的临床疗效及其对患者肝功能及肝纤维化指标的影响。方法:将80例患者按照随机数字表法分为对照组和观察组,每组各40例。对照组给予恩替卡韦,观察组在对照组的基础上加用养血柔肝汤。比较两组患者的临床疗效及治疗前后中医证候积分变化情况。检测两组患者治疗前后肝功能指标总胆红素(total bilirubin,TBIL)、丙氨酸氨基转移酶(alanine transaminase,ALT)、天冬氨酸氨基转移酶(aspartateaminotransferase,AST)、白蛋白(albumin,ALB)]和肝纤维化指标层粘连蛋白(laminin,LN)、透明质酸(hyaluronic acid,HA)、Ⅳ型胶原(Ⅳ-collagen,Ⅳ-C)、Ⅲ型前胶原(procollage typeⅢ,PCⅢ)]变化情况。结果:对照组有效率为67.50%,观察组有效率为90.00%,两组患者有效率比较,差异有统计学意义(P<0.05)。两组患者治疗后右胁隐痛、神疲乏力、胁下痞块、面色晦暗、失眠多梦等中医证候积分低于同组治疗前,且观察组各项中医证候积分低于对照组,差异有统计学意义(P<0.05)。观察组患者治疗后AST、ALT、TBiL低于治疗前,ALB高于治疗前,对照组患者治疗后AST、ALT、TBiL低于治疗前,观察组治疗后AST、ALT、TBiL低于对照组,ALB高于对照组,差异均有统计学意义(P<0.05)。两组患者治疗后LN、HA、IV-C、PCⅢ检测结果均明显低于同组治疗前,且观察组治疗后低于对照组,差异有统计学意义(P<0.05)。结论:养血柔肝汤联合恩替卡韦治疗慢性乙型病毒性肝炎肝纤维化,可改善患者临床症状、肝功能及肝纤维化指标。

Blood-Nourishing and Liver-Softening Decoction Combined with Entecavir in the Treatment of Liver Fibrosis of Chronic Hepatitis B

Objective:To observe the clinical curative effect of Blood-Nourishing and Liver-Softening Decoction combined with entecavir on liver fibrosis of chronic hepatitis B and its influence on liver function and liver fibrosis indexes.Methods:A total of 80 patients with liver fibrosis of chronic hepatitis B were divided into the control group and the observation group according to random number table method,with 40 cases in each group.The control group was given entecavir,and the observation group was added with Blood-Nourishing and Liver-Softening Decoction on the basis of the control group.The clinical effects of the two groups and the changes of TCM syndrome scores before and after the treatment were compared.The changes of the indexes of liver function indexes including total bilirubin(TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST),albumin(ALB),and liver fibrosis indexes including laminin(LN),hyaluronic acid(HA),collagen type IV) were measured(Ⅳ-C),Ⅲ procollagen(PC Ⅲ) before and after the treatment in the two groups were measured.Results:The effective rate was 67.50% in the control group and 90.00% in the observation group.The difference between the two groups was statistically significant(P<0.05).After the treatment,the scores of right flank pain,mental fatigue,hypochondriac lump,dark complexion,insomnia and dreaminess in the two groups were lower than those in the same group before the treatment,and the scores of various TCM syndromes in the observation group were lower than those in the control group,and all the differences were statistically significant(P<0.05).After the treatment,AST,ALT and TBiL in the observation group were lower than those before the treatment,ALB was higher than that before the treatment;AST,ALT and TBiL in the control group were lower than those before the treatment;AST,Alt,TBiL in the observation group were lower than those in the control group,ALB was higher than that in the control group,and all the differences were statistically significant(P<0.05).After the treatment,the detection results of LN,HA,IV-C and PC Ⅲ in the two groups were significantly lower than those before the treatment in the same group,and all the differences were statistically significant(P<0.05).Conclusion:Blood-Nourishing and Liver-Softening Decoction combined with entecavir has a remarkable efficacy on liver fibrosis of chronic hepatitis B,can improve symptoms and signs,liver function and liver fibrosis indexes of the patients.