肝康颗粒联合恩替卡韦在慢性乙型肝炎治疗中的应用探讨  

Application of Combined Therapy of Gankang Granule and Entecavir for Patients with Chronic Hepatitis B

作　　者：王林 张鸿 高峰 范合璋 

机构地区：[1]成都市公共卫生临床医疗中心三病区,成都610061

出　　处：《华西医学》2016年第4期688-691,共4页West China Medical Journal

摘　　要：目的探讨中药肝康颗粒与恩替卡韦联合治疗慢性乙型肝炎(乙肝)的临床疗效。方法选取2012年1月—2013年1月收治的慢性乙肝患者118例,随机分为治疗组(A组)和对照组(B组),每组59例患者。对照组给予口服恩替卡韦,治疗组在对照组的基础上加用中药肝康颗粒联合治疗。结果治疗前两组患者的肝纤维化评价指标血清透明质酸(HA)、层黏连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(CⅣ)比较,差异无统计学意义(P>0.05)。治疗后两组患者的HA、LN、PCⅢ及CⅣ比较,差异有统计学意义(P<0.05)。治疗48周后两组患者的血清谷丙转氨酶复常率比较,差异有统计学意义(P<0.05);乙肝病毒DNA转阴率、慢性乙肝e抗原转阴率及慢性乙肝e抗体转阳率比较,差异无统计学意义(P>0.05)。治疗48周后分别对两组45例患者进行肝活体组织检查,对肝纤维化改善的情况对比发现,A组患者肝纤维化较B组患者改善明显,差异有统计学意义(P<0.05)。结论采用中药肝康颗粒联合抗病毒药物恩替卡韦治疗慢性乙肝,其在保肝、改善肝纤维化的临床效果优于单用抗病毒药物恩替卡韦,联合用药的方法值得在临床上推广。Objective To investigate the clinical ei cacy of combined therapy of Gankang Granule and Entecavir for patients with chronic hepatitis B.Methods A total of 118 patients with chronic hepatitis B treated between January 2012 and January 2013 were randomly divided into treatment group（n=59） and control group（n=59）.Patients in the treatment group were treated with Gankang Granule and Entecavir,while those in the control group were treated with Entecavir alone.Results Before treatment,there was no significant difference between the two groups in such liver fibrosis evaluation indexes as hyaluronic acid（HA）,laminin（LN）,procollagen Ⅲ（PC Ⅲ）,and collegen type Ⅳ（C Ⅳ）（P〈 0.05）.At er treatment,the two groups had signii cant dif erences in HA,LN,PC Ⅲ,and C Ⅳ（P〈 0.05）.At er 48 weeks of treatment,the alanine aminotransferase recovery rate was significantly different between the two groups（P〈 0.05）; but there was no signii cant dif erence in hepatitis B virus DNA negative conversion rate,hepatitis B e antigen negative conversion rate and hepatitis B e antibody seroconversion rate（P〉 0.05）.Forty-eight weeks after treatment began,45 patients underwent liver biopsy which showed that liver fibrosis alleviation was significantly better in the treatment group than the control group（P〈 0.05）.Conclusions Gankang granule combined with antiviral drug Entecavir for chronic hepatitis B is better in protecting the liver and alleviating hepatic i brosis than the sole Entecavir.The combined method is worthy of being promoted.

关 键 词：慢性乙型肝炎 治疗 肝康颗粒 恩替卡韦 

分 类 号：R512.62[医药卫生—内科学]