恩替卡韦联合复方益肝灵胶囊治疗慢性乙型病毒性肝炎效果  

Effect of entecavir combined with Compound Yiganling capsule on chronic viral hepatitis B

作　　者：陈秋波 周武娟 谢艳霞 聂金金 Chen Qiubo;Zhou Wujuan;Xie Yanxia;Nie Jinjin(Zhangshu People's Hospital,Jiangxi 331200)

机构地区：[1]江西省樟树市人民医院,江西331200

出　　处：《天津药学》2021年第6期33-37,共5页Tianjin Pharmacy

摘　　要：目的:探讨恩替卡韦联合复方益肝灵胶囊治疗慢性乙型病毒性肝炎对谷丙转氨酶(ALT)复常率及药物不良反应的影响。方法:选取2017年2月—2020年1月本院收治的78例慢性乙型病毒性肝炎患者,随机数字法分为对照组(n=39)和研究组(n=39)两组。对照组采用恩替卡韦治疗,1次/d,0.5 mg/次,治疗过程中如果患者出现耐药突变或病毒血症,应调整用药剂量为1.0 mg/次,1次/d,连续用药48周;研究组在对照组基础上给予复方益肝灵治疗,3次/d,4粒/次,连续用药48周。比较两组患者ALT复常率、不良反应发生率、肝功能、肝纤维化指标、炎性因子水平及疗效。结果:与对照组比较,研究组ALT复常率更高(P<0.05),两组不良反应发生率无明显差异(P>0.05);治疗前,两组天冬氨酸转氨酶与血小板比值(APRI)、血小板(PLT)、剪切波瞬时弹性成像(Fibro Scan)、谷草转氨酶(AST)等肝脏功能指标无明显差异(P>0.05),治疗后,与对照组比较,研究组APRI和PLT水平更高,Fibro-scan和AST水平更低(P<0.05);治疗前,两组甘胆酸、血清Ⅳ型胶原(Ⅳ-C)、透明质酸(HA)、Ⅲ型前胶原(PCⅢ)和层黏连蛋白(LN)水平无明显差异(P>0.05),治疗后,与对照组比较,研究组甘胆酸、HA、Ⅳ-C、PCⅢ和LN水平更低(P<0.05);与对照组比较,研究组HbeAg转阴、HbeAg/抗Hbe转换和HBV-DNA转阴率更高(P<0.05);治疗前,两组炎性因子水平无明显差异(P>0.05),治疗后,与对照组比较,研究组超敏C反应蛋白(hs-CRP)、血清肿瘤坏死因子(TNF-α)、白介素-8(IL-8)和白介素-6(IL-6)水平更低(P<0.05)。结论:对慢性乙型病毒性肝炎患者进行恩替卡韦联合复方益肝灵胶囊治疗,效果理想,可改善患者肝功能,降低ALT复常率与炎性因子水平,且治疗安全性较高。所以,恩替卡韦联合复方益肝灵胶囊治疗应广泛应用。Objective:To investigate the effects of entecavir combined with Compound Yiganling capsule on ALT normalization rate and adverse reactions in the treatment of chronic viral hepatitis B.Methods:78 patients with chronic viral hepatitis B admitted to our hospital from February 2017 to January 2020 were randomly divided into the control group(n=39)and the study group(n=39).The control group was treated with entecavir(0.5 mg/time)once a day.If the patient had a drug resistance mutation or viremia during the treatment,the dosage should be adjusted to 1.0 mg/time,once a day.Patients in the control group were treated continuously for 48 weeks.Based on the control group,the study group was treated with compound Yiganling capsule(4 capsules/time)three times per day,and the patients were treated continuously for 48 weeks.The normalization rate of total bilirubin,the incidence of adverse reactions,liver function,and inflammatory factors were compared between the two groups.Results:Compared with the control group,the normalization rate of ALT in the study group was higher(P<0.05),and there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Before treatment,there were no significant differences in liver function indexes such as aspartate aminotransferase/platelet ratio(APRI),platelet(PLT),Fibro Scan,aspartate aminotransferase(AST)between the two groups(P>0.05).After treatment,compared with the control group,the levels of APRI and PLT were higher in the study group,while the levels of Fibro-Scan and AST were lower(P<0.05).Before treatment,there were no significant differences in the levels of glycocholic acid,serum typeⅣcollagen(Ⅳ-C),hyaluronic acid(HA),typeⅢprocollagen(PCⅢ),and laminin(LN)between the two groups(P>0.05).After treatment,the levels of glycocholic acid,HA,Ⅳ-C,PCⅢ,and LN in the study group were lower than those in the control group(P<0.05).Compared with the control group,the HBeAg conversion,HBeAg/anti-HBE conversion,and HBV-DNA conversion rates were highe

关 键 词：恩替卡韦 复方益肝灵胶囊 慢性乙型病毒性肝炎 ALT复常率 

分 类 号：R978.7[医药卫生—药品]