化浊抗纤保肝汤联合恩替卡韦对慢性乙型肝炎后肝纤维化患者的临床疗效

目的探讨化浊抗纤保肝汤联合恩替卡韦对慢性乙型肝炎后肝纤维化患者的临床疗效。方法 104例患者随机分为对照组和观察组,每组52例,对照组给予恩替卡韦,观察组在对照组基础上加用化浊抗纤保肝汤,疗程3个月。检测临床疗效、肝功能指标谷丙氨基转移酶(ALT)、谷草氨基转移酶(AST)、总胆红素(TBIL)]、肝纤维化指标层粘连蛋白(LN)、Ⅳ型胶原(Ⅳ-C)、透明质酸酶(HA)、Ⅲ型前胶原(PC-Ⅲ)]、TGF-β1、MMP-1、TIMP-1、组织学评分、肝脾B超指标(肝门静脉主干内径、脾门厚度)变化。结果观察组总有效率高于对照组(P<0.05)。治疗后,2组肝功能指标、肝纤维化指标、TGF-β1和TIMP-1水平、组织学评分、肝脾B超指标降低(P<0.05),MMP-1水平升高(P<0.05),以观察组更明显(P<0.05)。结论化浊抗纤保肝汤联合恩替卡韦可有效改善慢性乙型肝炎后肝纤维化患者肝功能与肝纤维化程度,抑制TGF-β1表达,调节MMP-1/TIMP-1平衡。

Clinical effects of Huazhuo Kangxian Baogan Decoction combined with entecavir on patients with liver fibrosis after chronic hepatitis B

AIM To explore the clinical effects of Huazhuo Kangxian Baogan Decoction combined with entecavir on patients with liver fibrosis after chronic hepatitis B.METHODS One hundred and four patients were randomly assigned into control group(52 cases) for 3-month administration of entecavir, and observation group(52 cases) for 3-month administration of both Huazhuo Kangxian Baogan Decoction and entecavir. The changes in clinical efficacy, liver function indices alanine aminotransferase(ALT), aspartate aminotransferase(AST), total bilirubin(TBIL)], liver fibrosis indices laminin(LN), type Ⅳ collagen(Ⅳ-C), hyalaronic acid(HA), procollagen type Ⅲ(PC-Ⅲ)], TGF-β1, MMP-1, TIMP-1, histological score, and ultrasonic B indices for liver and spleen were detected.RESULTS The observation group demonstrated higher total effective rate than the control group(P<0.05). After the treatment, the two groups displayed decreased liver function indices, liver fibrosis indices, TGF-β1 and TIMP-1 levels, histological score, and liver and spleen B ultrasonic indices(P<0.05), along with increased MMP-1 level(P<0.05), especially for the observation group(P<0.05).CONCLUSION For the patients with liver fibrosis after chronic hepatitis B, Huazhuo Kangxian Baogan Decoction combined with entecavir can effectively improve liver functions and liver fibrosis degree, inhibit TGF-β1 expression, and regulate the balance between MMP-1 and TIMP-1.