白花香莲解毒颗粒联合恩替卡韦治疗乙型肝炎肝硬化疗效观察  

Observation of therapeutic effect of Baihua Xianglian Jiedu Granules combined with entecavir on hepatitis B cirrhosis

作　　者：黄鹏 邱华[2] 范春娇 毛德文[2] 唐秋媛 李旺 蒙荫杰 何锦轶 HUANG Peng;QIU Hua;FAN Chunjiao;MAO Dewen;TANG Qiuyuan;LI Wang;MENG Yinjie;HE Jinyi(Guangxi University of Traditional Chinese Medicine, Nanning 530001, Guangxi, China;The First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine, Nanning 530023, Guangxi, China)

机构地区：[1]广西中医药大学,广西南宁530001 [2]广西中医药大学第一附属医院,广西南宁530023

出　　处：《现代中西医结合杂志》2021年第3期245-249,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：国家自然科学基金资助项目(81660827,81860889);中国博士后科学基金面上项目(2019M653312);广西自然科学基金面上项目(2020JJA140308);广西重点研发计划项目(2017AB45166);第二批广西高层次骨干人才培养139计划(桂卫科教发[2018]22号);广西中医药大学研究生教育创新计划项目(YCSY20190033)。

摘　　要：目的观察白花香莲解毒颗粒联合恩替卡韦治疗乙型肝炎肝硬化的临床疗效及安全性。方法将2017年1月—2019年1月在广西中医药大学第一附属医院治疗的134例乙型肝炎肝硬化患者随机分为治疗组与对照组,每组67例。对照组采用恩替卡韦治疗,治疗组在对照组治疗基础上加服白花香莲解毒颗粒。观察比较2组患者治疗24周、48周后血清谷丙转氨酶(ALT)和总胆红素(TBil)复常率、HBV DNA转阴率、肝纤维化指标、肝硬度值、临床治疗总有效率及不良反应发生情况。结果治疗24周后,治疗组ALT、TBil复常率与同期对照组比较差异均无统计学意义(P均>0.05),HBV DNA转阴率明显高于同期对照组(P<0.05);治疗48周后,治疗组ALT、TBil复常率及HBV DNA转阴率均明显高于同期对照组(P均<0.05)。治疗24周、48周后,2组透明质酸(HA)、层黏连蛋白(LN)、Ⅲ型前胶原(PC-Ⅲ)和Ⅳ型胶原(Ⅳ-C)水平及肝硬度值均明显低于治疗前(P均<0.05),且治疗48周后明显低于治疗24周后(P均<0.05);治疗组治疗24周、48周后HA、LN、PC-Ⅲ、Ⅳ-C水平及肝硬度值均明显低于同期对照组(P均<0.05)。治疗组治疗24周、48周后总有效率分别为86.57%(58/67)和91.04%(61/67),对照组分别为67.16%(47/67)和73.13%(49/67),治疗组均明显高于同期对照组(P均<0.05)。2组均未见血尿便常规及肾功能异常,且未见明显药物不良反应。结论白花香莲解毒颗粒联合恩替卡韦治疗乙型肝炎肝硬化临床疗效确切,安全性好。Objective It is to observe the clinical efficacy and safety of Baihua Xianglian Jiedu Granule combined with entecavir in the treatment of hepatitis B cirrhosis.Methods 134 patients with hepatitis B cirrhosis treated in the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine from January 2017 to January 2019 were randomly divided into a treatment group and a control group,with 67 cases in each group.The control group was treated with entecavir,and the treatment group was treated with Baihua Xianglian Jiedu Granule on the basis of the control group.The recovery rate of serum alanine aminotransferase(ALT)and total bilirubin(TBil),HBV DNA conversion rate,liver fibrosis indexes,liver stiffness value,and efficiency of clinical treatment and occurrence of adverse reactions after treatment for 24 weeks and 48 weeks were observed and compared in the two groups.Results After 24 weeks of treatment,there was no significant difference in the recovery rate of ALT and TBil between the treatment group and the control group during the same period(P>0.05),and the negative rate of HBV DNA was significantly higher than that of the control group during the same period(P<0.05);after treatment for 48 weeks,the recovery rate of ALT,TBil and HBV DNA conversion rate in the treatment group were significantly higher than those in the control group during the same period(P<0.05).After 24 and 48 weeks of treatment,the levels of hyaluronic acid(HA),laminin(LN),typeⅢprocollagen(PC-Ⅲ)and typeⅣcollagen(Ⅳ-C)and liver stiffness in the two groups were all significantly lower than those before treatment(P<0.05),and these indexes after 48 weeks of treatment were significantly lower than those after 24 weeks of treatment(P<0.05);the levels of HA,LN,PC-Ⅲ,Ⅳ-C and liver stiffness value in the treatment group after 24 and 48 weeks of treatment were significantly lower than those in the control group during the same period(P<0.05).The total effective rates after 24 and 48 weeks of treatment in the treatment group were

关 键 词：乙型肝炎肝硬化 白花香莲解毒颗粒 恩替卡韦 

分 类 号：R657.31[医药卫生—外科学]