肝爽颗粒联合多烯磷脂酰胆碱治疗慢性乙型肝炎的临床研究

目的研究肝爽颗粒联合多烯磷脂酰胆碱注射液治疗慢性乙型肝炎的临床疗效。方法选取2016年8月—2018年8月西安交通大学第二附属医院收治的120例慢性乙型肝炎患者为研究对象,将所有患者采用随机数字表法分为对照组和治疗组,每组各60例。对照组患者静脉滴注多烯磷脂酰胆碱注射液,15m L加入到5%葡萄糖注射液250m L中,1次/d;治疗组患者在对照组基础上口服肝爽颗粒,1袋/次,3次/d。两组患者连续治疗4周。观察两组的临床疗效,比较两组的肝功能指标、肝纤维化指标、乙型肝炎病毒脱氧核糖核酸(HBV-DNA)转阴率、乙型肝炎e抗原(HBeAg)转阴率。结果治疗后,对照组和治疗组的总有效率分别为81.67%、95.00%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、谷氨酰转肽酶(GGT)和总胆红素(TBIL)水平均显著降低,同组治疗前后比较差异有统计学意义(P0.05);并且治疗组患者AST、ALT、GGT和TBIL水平均明显低于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组患者透明质酸(HA)、Ⅲ型前胶原(PcⅢ)、层黏连蛋白(LN)、Ⅳ型胶原(IV-C)水平显著降低,同组治疗前后比较差异有统计学意义(P0.05);并且治疗组患者HA、PcⅢ、LN和IV-C水平均明显低于对照组,两组比较差异有统计学意义(P0.05)。治疗后,对照组和治疗组HBV-DNA转阴率分别为16.67%、33.33%,HBeAg转阴率分别为31.67%、58.33%,两组比较差异有统计学意义(P0.05)。结论肝爽颗粒联合多烯磷脂酰胆碱注射液治疗慢性乙型肝炎具有较好的临床疗效,能够改善患者肝功能和肝纤维化水平,提高HBV-DNA转阴率和HBeAg转阴率,具有一定的临床推广应用价值。

Clinical study on Ganshuang Granules combined with Polyene Phosphatidylcholine in treatment of chronic hepatitis B

Objective To study the efficacy of Ganshuang Granules combined with Polyene Phosphatidylcholine Injection in treatment of chronic hepatitis B. Methods Patients (120 cases) with chronic hepatitis B in the Second Affiliated Hospital of Xi'an Jiaotong University from August 2016 to August 2018 were randomly divided into control and treatment groups, and each group had 60 cases. Patients in the control group were iv administered with Polyene Phosphatidylcholine Injection, 15 mL added into 5% glucose solution 250 mL, once daily. Patients in the treatment group were po administered with Ganshuang Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and liver function indexes, liver fibrosis indexes, HBV-DNA conversion rate, and HBeAg conversion rate in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 81.67% and 95.00%, respectively, and there was difference between two groups (P<0.05). After treatment, the levels of AST, ALT, GGT, and TBIL in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the liver function indexes levels in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of HA, PcⅢ, LN, and IV-C in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the liver fibrosis indexes levels in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the HBV-DNA conversion rates in the control and treatment groups were 16.67% and 33.33%, respectively, and the HBeAg conversion rates in the control and treatment groups were 31.67% and 58.33%, respectively, and there was difference between two groups (P<0.05). Conclusion Ganshuang Granules combined with Polyene Phosphatidylcholine Injection has clinical curative effect in treatment of chronic hepatitis B, can improve liver function and liver fibrosis, and increase HBV-DNA conversion rate and HBeAg conversion rate, which has a certain clinical application value.