中药软肝煎加减联合恩替卡韦对乙肝型肝纤维化患者肝功能及病毒学应答的影响  

Effect of Ruangan Decoction Combined with Entecavir on Liver Function and Virological Response for Patients with Hepatitis B Fibrosis

作　　者：赵健[1] ZHAO Jian(Department of Hepatology,Traditional Chinese Medicine Hospital of Taihe County,Taihe Anhui 236600,China)

机构地区：[1]太和县中医院肝病科,安徽太和236600

出　　处：《四川中医》2020年第8期114-117,共4页Journal of Sichuan of Traditional Chinese Medicine

摘　　要：目的:观察中药软肝煎加减联合恩替卡韦对乙肝型肝纤维化患者肝功能及病毒学应答的影响。方法:选取2016年5月~2019年2月我院收治的乙肝型肝纤维化患者106例,采用随机数字表法分为联合组和常规组各53例,常规组接受常规抗病毒治疗,服用恩替卡韦,联合组采用中药软肝煎加减联合恩替卡韦治疗,治疗一个月后观察比较两组中医证候疗效、病毒学指标[乙肝e抗原(HBe Ag)、乙型肝炎病毒-脱氧核糖核酸(HBV-DNA)]、肝功能指标[丙氨酸氨基转移酶(ALT)、白蛋白(ALB)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)]水平及不良发应发生情况。结果:联合中医证候总疗效(88.68%)明显高于常规组(64.15%),差异具有统计学意义(P<0.05);治疗前,两组HBe Ag、HBV-DNA、ALT、AST、ALB、TBIL水平比无显著差异(P>0.05);治疗后,两组HBe Ag、HBV-DNA、ALT、AST、TBIL水平与治疗前比较显著下降,ALB水平显著增加(P<0.05),联合组HBe Ag、HBV-DNA、ALT、AST、TBIL水平明显低于常规组,ALB水平显著高于常规组(P<0.05);两组不良反应发生率(7.55%、5.66%)比较无显著差异(P>0.05)。结论:中药软肝煎加减联合恩替卡韦对乙肝型肝纤维化疗效确切,能有效提高中医证候疗效,改善病毒学反应,增强肝功能,且不会增加不良反应,值得临床推广应用。Objective:To investigate the effect of Ruangan Decoction combined with Entecavir on liver function and virological response for patients with hepatitis B fibrosis.Methods:106cases of hepatitis B fibrosis in our hospital from May 2016to February 2019were enrolled,and divided into two groups by random number table methods,each with 53cases.The routine group received Entecavir,while the combined group received Ruangan Decoction combined with Entecavir.One month after treatment,various indexes were compared between groups,including TCM syndromes score,level of virological indexes[hepatitis B e antigen(HBeAg),hepatitis B virus DNA(HBV-DNA)],liver function indexes[alanine aminotransferase(ALT),albumin(ALB),aspartate aminotransferase(AST),total bilirubin(TBIL)]and adverse events.Results:TCM syndrome total efficacy of the combined group was higher than that of the routine group(88.68%vs 64.15%,P<0.05).Levels of HBeAg,HBV-DNA,ALT,AST,ALB and TBIL had no difference between groups(P>0.05).After treatment,the levels of HBeAg,HBV-DNA,ALT,AST,and TBIL were significantly decreased in both groups(P<0.05),and were lower in the combined group than in the routine group(P<0.05).ALB level was increased in both groups after treatment(P<0.05),and was higher in the combined group than in the routine group(P<0.05).The incidence rate of the adverse reaction had no difference between groups(7.55%vs 5.66%,P>0.05).Conclusion:Ruangan Decoction combined with Entecavir can effectively ameliorate the virological response and enhance liver function for patients with hepatitis B fibrosis,without increasing the adverse reactions,and it is worthy of clinical application.

关 键 词：乙肝型肝纤维化 软肝煎 恩替卡韦 病毒学应答 肝功能 

分 类 号：R575.2[医药卫生—消化系统]