复方鳖甲软肝片联合恩替卡韦对HBV相关肝硬化患者的临床疗效观察  

Clinical effect of combination therapy with Fufang Biejia Ruangan tablet and entecavir in patients with hepatitis B virus-related cirrhosis

作　　者：吴刚[1] 何鸿雁[2] 李烨[1] 陈文[1] 

机构地区：[1]泸州医学院附属医院,646000 [2]泸州医学院公共卫生学院

出　　处：《中华肝脏病杂志》2014年第8期604-608,共5页Chinese Journal of Hepatology

基　　金：王宝恩肝纤维化研究基金，四川省科技厅资助项目

摘　　要：目的探讨复方鳖甲软肝片联合恩替卡韦对慢性乙型肝炎肝硬化患者肝纤维化指标的影响及其临床疗效。方法选择2010年3月至2012年8月期间接受治疗的慢性乙型肝炎肝硬化患者163例，分为复方鳖甲软肝片联合恩替卡韦治疗组（A组，n=56），恩替卡韦单独治疗组（B组，n=52）和复方鳖甲软肝片单独治疗组（C组，n=55），疗程12个月。检测各组患者血清透明质酸（HA）、层黏连蛋白（LN）、IV型胶原（PCIV）和脯肽酶（PLD）浓度，肝活组织病理学检测肝脏纤维化分级，Fibroscan检测肝脏硬度。组内比较采用配对t检验，两组间均数比较采用t检验，多组间比较采用方差分析，计数资料比较采用x^2检验。结果治疗后3组患者ALT、AST、HBVDNA定量、HA、LN、PCIV和PLD水平较治疗前均显著下降（P＜0．05）。A组HA、LN、PCIV和PLD水平下降程度较B组、C组明显P＜0．05）。3组患者治疗后肝组织纤维化分级和肝脏硬度值较治疗前均明显降低（P＜0．05），A组肝纤维化改善程度更为明显护〈0．05）。A组显效率和有效率分别为57．14％、82．14％，显著高于B组和C组（P＜0．05）。结论复方鳖甲软肝片联合恩替卡韦治疗对于改善慢性乙型肝炎肝硬化患者肝纤维化有良好疗效。Objective To investigate the clinical effect of combination therapy with Fufang Biejia Ruangan tablet and entecavir in patients with hepatitis B virus （HBV）-related cirrhosis. Methods A total of 163 patients with HBV-related cirrhosis were recruited for treatment between March 2010 and August 2012, and divided into the following three groups： group A （n = 56） received Fufang Biejia Ruangan Tablet plus entecavir; group B （n = 52） received entecavir only; and group C （n = 55） received Fufang Biejia Ruangan tablet only. Enzyme-linked immunoassay methods were used to measure serum levels ofhyaluronic acid （HA）, laminin （LN）, collagen （PCIV） and prolyl endopeptidase （PLD）. The grade of liver fibrosis was determined upon liver biopsy, and score of liver stiffness was measured by FibroScan. Results All three treatment groups showed significant decreases from baseline in serum levels of alanine aminotransferase, asparmte aminotransferase, HBV DNA, HA, LN, PCIV and PLD （all P 〈0.05）. However, the changes in HA, LN, PCIV and PLD levels were significantly greater in group A than in either group B or C （P 〈0.05）. All three treatment groups showed significant improvements from baseline in liver fibrosis grade and liver stiffness score （P 〈0.05）. The total effective rate of group A was 82.14%, which was significantly higher than that of groups B and C （P 〈0.05）. Conclusion Combination therapy of Fufang Biejia Ruangan tablet plus entecavir is effective for treating HBV-related cirrhosis.

关 键 词：肝硬化 肝炎病毒 乙型 复方鳖甲软肝片 恩替卡韦 

分 类 号：R575.2[医药卫生—消化系统]