一贯煎加味联合恩替卡韦胶囊治疗慢性乙型肝炎后肝硬化的临床疗效及对肝功能及肝纤维化的影响  

Effect of using Modified Yiguanjian Decoction Combined with Entecavir Capsule on Clinical Efficacy,Liver Function and Liver Fibrosis in the Treatment of Patients with Liver Cirrhosis after Chronic Hepatitis B

作　　者：袁志军 刘乡[2] 朱海容 梁英 YUAN Zhijun;LIU Xiang;ZHU Hairong(Department of Traditional Chinese Medicine,Shuixiang Central Hospital of Dongguan Cigty,Dongguan Guangdong 523000,China;Department of Endocrinology,the Second Hospital of Traditional Chinese Medicine of Guangdong Province,Guangzhou Guangdong 510095,China)

机构地区：[1]东莞市水乡中心医院中医科,广东东莞523000 [2]广东省第二中医院内分泌科,广东广州510095

出　　处：《四川中医》2020年第5期124-127,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：广东省中医药管理局科研课题(编号:2010WK0062010447)。

摘　　要：目的:分析一贯煎加味联合恩替卡韦胶囊治疗对慢性乙型肝炎(Chronic Hepatitis B,CHB)后肝硬化患者临床疗效、肝功能及肝纤维化的影响。方法:选取本院2017年3月~2019年4月收治的76例CHB后肝硬化患者,将患者根据治疗方式不同分为观察组(一贯煎加味联合恩替卡韦胶囊)46例和对照组(恩替卡韦胶囊)30例。观察两组患者治疗临床效果,比较两组患者治疗前后肝功能、血清肝纤维化四项及血清炎性因子表达水平。结果:治疗后观察组总有效率为84.21%,明显优于对照组57.89%.(P<0.05);治疗前两组患者肝功能、血清肝纤维化四项、血清炎性因子水平况比较无差异(P>0.05),治疗后肝功能、血清肝纤维化四项、血清炎性因子均较治疗前有所改善(P<0.05);但观察组患者ALT、AST、TBIL下降水平和PC-III、PCIV、HA、LN下降水平与对照组比较幅度更大(P<0.05);治疗后两组患者IL-6、TNF-α水平均有下将;INF-γ、IL-10水平上升;而观察组IL-6、INF-γ、IL-10、TNF-α表达水平改善情况优于对照组(P<0.05);观察组不良反应发生率较对照组低,但比较差异间无统计学意义(P<0.05)。结论:一贯煎加味联合恩替卡韦胶囊治疗对CHB后肝硬化患者治疗效果优于单独治疗,可改善患者症状,减少肝硬纤维化程度,减轻炎症反应,保护肝功能,不增加患者不良反应发生,值得临床推广使用。Objective: To analyze the effect of Modified Yiguanjian Decoction combined with Entecavir Capsule on clinical efficacy,liver function and liver fibrosis for patients with liver cirrhosis after chronic hepatitis B(CHB).Methods: 76 patients with cirrhosis after CHB admitted from March 2017 to April 2019 in our hospital were selected.The patients were divided into observation group(Modified Yiguanjian Decoction combined with Entecavir Capsule),46 cases,and controlled group(Entecavir Capsule),30 cases according to different treatment.The clinical effects of the two groups were observed.The levels of liver function,serum fibrosis and serum inflammatory factors were compared between the two groups before and after treatment.Results: After treatment,the total effective rate of the observation group was 84.21%,which was significantly better than that of the controlled group(57.89%)(P<0.05).There was no difference in liver function,serum liver fibrosis and serum inflammatory factor levels between the two groups before treatment(P>0.05).After treatment,liver function,serum fibrosis and serum inflammatory factors improved(P<0.05).However,the decreasing of ALT,AST,TBIL and the decreasing of PC-III,PCIV,HA and LN in the observation group were greater than those in the controlled group(P<0.05).After treatment,the levels of IL-6 and TNF-α in the two groups were lower,and the levels of INF-γ and IL-10 increased.The improvement of IL-6,INF-γ,IL-10 and TNF-α in the observation group were better than those in the controlled group(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the controlled group,but there was no significant difference between the two groups(P<0.05).Conclusion: Using Modified Yiguanjian Decoction combined with Entecavir Capsule in the treatment of patients with cirrhosis after CHB is better than that of Entecavir Capsule alone,and it can improve the symptoms of patients,reduce the degree of liver fibrosis,reduce the inflammatory response,protect liver function,and do

关 键 词：一贯煎加味 恩替卡韦胶囊 慢性乙型肝炎后肝硬化 肝功能 肝纤维化 

分 类 号：R575.2[医药卫生—消化系统]