复方鳖甲软肝片治疗慢性乙型肝炎患者对血清肝纤维化指标的影响  

Serum hyaluronan,laminin,collagen type Ⅳ,and pro-collagen Ⅲ levels in patients with chronic hepatitis B receiving compound Biejia Ruangan tablets

作　　者：宫嫚[1] 辛绍杰[1] 邹正升[1] 李润东 徐庆会[3] 韩宝英[4] 于建国[5] 于德航 司雁菱 王宪波[8] 候爱画 李秀惠[10] 陈菊梅[1] 

机构地区：[1]解放军第302医院感染性疾病与诊疗中心,北京市100039 [2]山东省枣庄市中医医院肝病科 [3]潍坊市中医院肝胆内科 [4]河南省安阳市第五人民医院 [5]解放军第88医院肝病科 [6]山东省青岛市第五人民医院 [7]河北省唐山市工人医院消化内科 [8]北京地坛医院中西医结合肝病科 [9]山东省烟台市中医院肿瘤科 [10]首都医科大学附属佑安医院中西医结合科

出　　处：《实用肝脏病杂志》2015年第6期585-589,共5页Journal of Practical Hepatology

摘　　要：目的评估复方鳖甲软肝片治疗慢性乙型肝炎患者对血清肝纤维化指标的影响。方法将304例慢性乙型肝炎分为试验组219例和对照组85例。给予试验组口服复方鳖甲软肝片,对照组口服安络化纤丸,疗程24w。采用ELISA法检测透明质酸(HA)、黏连蛋白(LN)、Ⅳ型胶原(c-Ⅳ)和Ⅲ型前胶原(PCⅢ)。结果在治疗24 w结束时,经中医症候疗效全分析集(FAS)分析,试验组显效率为72.9%,优于对照组的56.8%(P=0.004);试验组总有效率为89.3%,优于对照组的80.7%(P=0.029);试验组血清肝纤维化指标显效率为35.3%,优于对照组的22.2%(P=0.016);治疗后试验组血清透明质酸(HA)水平下降了(87.4±111.2)ng/m L,优于对照组下降的(61.2±66.2)ng/m L(P=0.01),两组血清LN、c-Ⅳ、PCⅢ水平变化无统计学差异(P>0.05);两组肝功能指标复常率差异无统计学意义(P>0.05);试验组未发现不良反应。结论复方鳖甲软肝片治疗慢性乙型肝炎患者安全、有效,可以改善肝纤维化指标。Objective To evaluate the efficacy of Compound Biejia Ruangan Tablets （RGP） on preventing the progression of liver fibrosis in patients with chronic hepatitis B （CHB）. Methods 304 patients with CHB were divided into treatment group（n=219）,and control group （n=85）. The patients in treatment group were given RGP orally at dose of 4 tablets,3 times daily,and in control group given Anluo Huaxian pills （ALHX） orally,at dose of 6 g,2 times daily. The serum hyaluronan,laminin,collagen type 1V ,and PC HI levels were detected by ELISA. Results At the end of 24-week treatment,the significant improvement of Chinese medicine symptom as assessed by curative effect full analysis set （FAS） in treatment group was 72.9%,higher than 56.8%（P=0.004） in control group;the total efficiency in treatment group was 89.3%,higher than 80.7% in control group（P=0.029）;The curative effect analysis of four items for liver fibrosis showed that the significant efficiency in treatment group was 35.3%,better than 22.2% in control group （P=O.O16）;the total effective rate was no statistically significantly different between the two groups;For serum liver fibrosis indexes,the hyaluronic acid in treatment group fell by （87.4±111.2） ng/mL,better than that in control group,which fe11（61.2±6.2） ng/mL after treatment （P=0.01）;The changes of serum laminin,typeiVcollagen and pro-collagen m in the two groups had no statistical differences （P〉 0.05）;The normalization rates of liver function indexes after treatment had no statistically significant difference between the two groups（P〉0.05）;In terms of safety,we found no adverse reaction in the two groups. Conclusion It is safe and effective to treat patients with CHB by RGP,which will improve the symptoms,and decrease serum liver fibrosis indexes.

关 键 词：慢性乙型肝炎 复方鳖甲软肝片 血清肝纤维化指标 临床疗效 

分 类 号：R259[医药卫生—中西医结合]