复方鳖甲软肝片联合恩替卡韦对乙肝肝硬化失代偿期患者疗效、肝功能、免疫功能影响研究  

Effect of Compound Biejia Ruanjian Tablet(复方鳖甲软肝片) Combined with Entecavir on Efficacy,Liver Function and Immune Function of Patients with Hepatitis B Cirrhosis at Decompensated Stage

作　　者：冯志刚 李涛[2] 赵冰清 张群 FENG Zhigang;LI Tao;ZHAO Bingqing;ZHANG Qun(Taihe Hospital of Anhui University of Traditional Chinese Medicine,Fuyang 236600,Anhui,China;First Affiliated Hospital of Anhui Medical University,Hefei 230000,Anhui,China)

机构地区：[1]安徽中医药大学附属太和中医院,安徽阜阳236600 [2]安徽医科大学第一附属医院,安徽合肥230000

出　　处：《中华中医药学刊》2022年第1期184-187,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：安徽省自然科学基金(1708085MH184)。

摘　　要：目的探究复方鳖甲软肝片结合恩替卡韦对乙肝肝硬化失代偿期患者疗效、肝功能、免疫功能的影响。方法研究合计纳入由医院2019年12月—2020年12月收治的93例乙肝肝硬化失代偿期患者,采取随机数字表法将其分为两组,予以对照组患者(46例)恩替卡韦治疗,予以观察组患者(47例)复方鳖甲软肝片结合恩替卡韦治疗,比较两组患者治疗效果、治疗前后中医症状(纳差、浮肿、乏力、胁肋隐痛、小便发黄等)积分变化、治疗前后患者肝硬度数值变化及肝纤维化指标变化、肝功能指标变化、腹腔积液深度及腹围、24 h尿量变化、T细胞亚群指标变化及并发症情况。结果观察组患者治疗总有效率(95.74%,45/47)高于对照组(80.43%,37/46),P<0.05;治疗前,两组患者纳差、浮肿、乏力、胁肋隐痛、小便发黄等中医症状积分、肝硬度数值、透明质酸(HA)及层粘连蛋白(LN)、Ⅲ型前胶原(PCⅢ)及Ⅳ型胶原(Ⅳ-Co)等肝纤维指标、前白蛋白(PAB)、白蛋白(ALB)及血清胆碱酯酶(CHE)等肝功能指标、腹腔积液深度及腹围、24 h尿量、CD^(+)_(3)、CD^(+)_(4)、CD^(+)_(8)、CD^(+)_(4)/CD^(+)_(8)等T细胞亚群指标比较,P>0.05;治疗后各组患者纳差、浮肿、乏力、胁肋隐痛、小便发黄等中医症状积分、肝硬度数值、HA、LN、PCⅢ、Ⅳ-Co、PAB、ALB、CHE、腹腔积液深度及腹围、24 h尿量、CD^(+)_(3)、CD^(+)_(4)、CD^(+)_(8)、CD^(+)_(4)/CD^(+)_(8)等指标均改善,观察组患者治疗后纳差、浮肿、乏力、胁肋隐痛、小便发黄等中医症状积分、肝硬度数值、HA、LN、PCⅢ、Ⅳ-Co、PAB、ALB、CHE、腹腔积液深度及腹围、24 h尿量、CD^(+)_(3)、CD^(+)_(4)、CD^(+)_(8)、CD^(+)_(4)/CD^(+)_(8)等指标均优于对照组(P<0.05);观察组患者并发症率(4.26%,2/47)低于对照组患者(17.39%,8/46)(P<0.05)。结论复方鳖甲软肝片结合恩替卡韦治疗乙肝肝硬化失代偿期疗效佳,患者症状改善,肝功能�Objective To explore the effects of Compound Biejia Ruanjian Tablet(复方鳖甲软肝片)combined with entecavir on the efficacy,liver function and immune function of patients with decompensated hepatitis B cirrhosis.Methods From December 2019 to December 2020,93 cases of patients with hepatitis B cirrhosis of the liver decompensation period in our hospital were analyzed.By taking a random number table method,they can be divided into two groups.The control group’s patients(46 cases)were treated with entecavir.The observation group’s patients(47 cases)were treated with Compound Biejia Ruanjian Tablet combined with entecavir.The treatment effect,the integral changes of traditional Chinese medicine symptoms(anorexia,edema,fatigue,hypochondriac pain,yellow urine,etc.)before and after treatment,the changes of liver hardness,liver fibrosis,liver function,peritoneal effusion depth and abdominal circumference,24 h urine volume,T cell subsets and complications were compared between the two groups.Results The total effective rate(95.74%,45/47)in the observation group was higher than that in the control group(80.43%,37/46)(P<0.05).Before treatment,the scores of TCM symptoms such as anorexia,edema,fatigue,hypochondriac pain,yellow urination,liver hardness,liver fiber indexes such as hyaluronic acid(HA),laminin(LN),typeⅢprocollagen(PCⅢ)and type IV collagen(IV-CO),liver function indexes such as prealbumin(PAB),albumin(ALB)and serum cholinesterase(CHE),depth of peritoneal effusion and abdominal circumference 24 h urine volume,T cell subsets such as CD^(+)_(3),CD^(+)_(4),CD^(+)_(8) and CD^(+)_(4)/CD^(+)_(8) were not significant(P>0.05).After treatment,the scores of TCM symptoms such as anorexia,edema,fatigue,hypochondriac pain,yellow urination,liver hardness,HA,LN,PCⅢ,Ⅳ-Co,PAB,ALB,CHE,depth and circumference of peritoneal effusion,24 h urine volume,CD^(+)_(3),CD^(+)_(4),CD^(+)_(8),CD^(+)_(4)/CD^(+)_(8) were improved.Those of the observation group were superior to those of the control group(P<0.05).The complication r

关 键 词：乙肝肝硬化失代偿期 复方鳖甲软肝片 恩替卡韦 疗效 肝功能 免疫功能 

分 类 号：R259.126.2[医药卫生—中西医结合] R269.573.1[医药卫生—中医内科学]