解郁软坚活血方辅助甘草酸二铵胶囊与恩替卡韦在HBV相关肝硬化患者中的应用效果观察  

Diammonium glycyrrhizinate capsules and entecavir assisted by Jieyu Ruanjian Huoxue Recipe for patients with HBV-related liver cirrhosis

作　　者：孟祥林 罗宏伟 Meng Xianglin;Luo Hongwei(Department of Spleen,Stomach,and Liver Diseases,Zhengzhou Hospital of Traditional Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]郑州市中医院脾胃肝病二科,450000

出　　处：《国际医药卫生导报》2021年第7期972-975,共4页International Medicine and Health Guidance News

基　　金：河南省中医药管理局项目(豫中医科教〔2018〕16号)。

摘　　要：目的探讨恩替卡韦、甘草酸二铵胶囊、解郁软坚活血方在乙型肝炎病毒(hepatitis B virus,HBV)相关肝硬化中的应用价值。方法选取2018年1月至2019年3月本院HBV相关肝硬化患者112例,依据随机数字表法分为研究组与对照组,各56例。对照组男32例,女24例;年龄(47.41±6.38)岁(31~64岁)。研究组男34例,女22例;年龄(46.97±6.68)岁(30~66岁)。对照组在常规治疗基础上给予恩替卡韦、甘草酸二铵胶囊,研究组在对照组的基础上加用解郁软坚活血方。统计两组患者临床疗效、肝功能[总胆红素(total bilirubin,TBIL)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)]及肝纤维化指标[Ⅲ型前胶原(typeⅢprocollagen,PCⅢ)、Ⅳ型胶原蛋白(typeⅣcollagen,Ⅳ-C)、层黏蛋白(laminin,LN)、透明质酸(hyaluronic acid,HA)]、肝硬度值、不良反应。结果研究组患者治疗总有效率(92.86%,52/56)高于对照组(78.57%,44/56)(P<0.05);治疗后,研究组TBIL为(20.51±3.67)μmol/L、AST为(40.61±6.30)U/L、ALT为(43.34±6.38)U/L,对照组分别为(29.15±4.03)μmol/L、(56.41±7.35)U/L、(59.54±8.66)U/L,研究组TBIL、AST、ALT血清水平均低于对照组(均P<0.05);治疗后,研究组血清PCⅢ为(96.64±19.59)μg/L、Ⅳ-C为(70.15±16.35)μg/L、LN为(126.71±26.38)μg/L、HA为(229.56±40.15)μg/L、肝硬度值为(18.13±1.60)kPa,对照组分别为(130.23±23.34)μg/L、(91.32±18.59)μg/L、(159.93±22.61)μg/L、(301.13±44.35)μg/L、(20.97±1.35)kPa,研究组血清PCⅢ、Ⅳ-C、LN、HA水平、肝硬度值均低于对照组(均P<0.05);研究组不良反应发生率为8.93%(5/56),对照组为5.36%(3/56),两组比较差异无统计学意义(P>0.05)。结论恩替卡韦、甘草酸二铵胶囊、解郁软坚活血方联合治疗HBV相关肝硬化,可有效改善肝功能及肝纤维化,效果显著,且具有安全性。Objective To explore the application value of entecavir,diammonium glycyrrhizinate capsules,and Jieyu Ruanjian Huoxue Recipe for hepatitis B virus(HBV)related liver cirrhosis.Methods From January,2018 to March,2019,112 patients with HBV-related cirrhosis treated at our hospital were selected and divided into a study group and a control group according to the simple random number table method,with 56 cases in each group.There were 32 males and 24 females in the control group;they were 31-64 years old,with an average of(47.41±6.38).There were 34 males and 22 females in the control group;they were 30-66 years old,with an average of(46.97±6.68).On a routine basis,the control group was given entecavir and diammonium glycyrrhizinate capsules;and the study group was given Jieyu Ruanjian Huoxue Recipe on the basis of the control group.The clinical efficacies,liver function,liver fibrosis indicators,and cirrhosis values of the two groups were counted.Results The total effective rate of the study group was higher than that of the control group[92.86%(52/56)vs.78.57%(44/56);P<0.05].The serum levels of total bilirubin(TBIL),aspartate aminotransferase(AST,)and alanine aminotransferase(ALT)in the study group were lower than those in the control group after the treatment[(20.51±3.67)μmol/L vs.(29.15±4.03)μmol/L,(40.61±6.30)U/L vs.(56.41±7.35)U/L,and(43.34±6.38)U/L vs.(59.54±8.66)U/L;all P<0.05]..After the treatment,the serum levels of typeⅢprocollagen(PCⅢ),typeⅣcollagen(Ⅳ-C),laminin(LN),and hyaluronic acid(HA)and liver fibrosis values in the study group were lower than those in the control group[(96.64±19.59)μg/L vs.(130.23±23.34)μg/L,(70.15±16.35)μg/L vs.(91.32±18.59)μg/L,(126.71±26.38)μg/L vs.(159.93±22.61)μg/L,(229.56±40.15)μg/L vs.(301.13±44.35)μg/L,(18.13±1.60)kPa,and(20.97±1.35)kPa;all P<0.05].The incidence of adverse reactions was 8.93%(5/56)in the study group,and was 5.36%(3/56)in the control group,with no statistical difference(P>0.05).Conclusion Entecavir,diammonium glycyrrhizinate

关 键 词：甘草酸二铵胶囊 解郁软坚活血方 恩替卡韦 HBV相关肝硬化 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]