软肝汤联合恩替卡韦治疗乙型病毒性肝炎肝硬化腹水临床观察  

Clinical Observation of Ruangan Decoction Combined with Entecavir in the Treatment of Cirrhotic Ascites Caused by Hepatitis B

作　　者：陈杰 高凌燕 CHEN Jie;GAO Lingyan(Luannan County Hospital,Tangshan,Hebei,China 063500)

机构地区：[1]河北省滦南县医院,河北唐山063500

出　　处：《中国药业》2023年第3期94-97,共4页China Pharmaceuticals

基　　金：河北省中医药管理局中医药类科研计划项目[2021427]。

摘　　要：目的探讨软肝汤联合恩替卡韦治疗乙型病毒性肝炎(简称乙肝)肝硬化腹水的临床疗效。方法选取医院2019年5月至2020年5月收治的乙肝肝硬化腹水患者108例,分为对照组和研究组,各54例。对照组患者予恩替卡韦治疗,研究组患者在对照组治疗基础上加用软肝汤,均治疗3个月。结果研究组患者的总有效率为92.59%,显著高于对照组的75.93%(P<0.05)。治疗后,两组患者的天门冬氨酸氨基转移酶(AST)、总胆红素(TBiL)、丙氨酸氨基转移酶(ALT)、碱性磷酸酶(ALP)水平均显著降低,且研究组均显著低于对照组(P<0.05);两组患者的T淋巴细胞亚群CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)均显著升高,CD_(8)^(+)均显著降低,且研究组变化均更显著(P<0.05);两组患者的热休克蛋白47(HSP47)、内皮型一氧化氮合酶(eNOS)、髓鞘碱性蛋白(MBP)水平均显著降低,且研究组患者均低于对照组(P<0.05);两组患者的乙肝表面抗原定量均显著减少,肝脏硬度值均显著降低,脾脏直径均显著缩小,且研究组变化更显著(P<0.05)。研究组和对照组患者治疗期间的不良反应发生率相当(14.81%比9.26%,P>0.05)。结论软肝汤联合恩替卡韦治疗乙肝肝硬化腹水的临床疗效良好,能改善患者的肝功能和免疫功能,抑制炎性因子的表达,且安全性良好。Objective To investigate the clinical efficacy of Ruangan Decoction combined with entecavir in the treatment of cirrhotic ascites caused by hepatitis B.Methods A total of 108 patients with cirrhotic ascites caused by hepatitis B admitted to the hospital from May 2019 to May 2020 were selected and divided into the control group and the study group,with 54 cases in each group.The patients in the control group were treated with entecavir,on this basis,the patients in the study group were treated with Ruangan Decoction.Both groups were treated for three months.Results The total effective rate in the study group was 92.59%,which was significantly higher than 75.93% in the control group(P<0.05).After treatment,the levels of aspartate aminotransferase(AST),total bilirubin(TBiL),alanine aminotransferase(ALT)and alkaline phosphatase(ALP)in the two groups were significantly lower,and those in the study group were significantly lower than those in the control group(P<0.05).After treatment,the T lymphocyte subsets CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)in the two groups were significantly higher,the CD_(8)^(+)in the two groups was significantly lower,and those in the study group changed more significantly than those in the control group(P<0.05).After treatment,the levels of heat shock protein 47(HSP47),endothelial nitric oxide synthase(eNOS)and myelin basic protein(MBP)in the two groups were significantly lower,and those in the study group were significantly lower than those in the control group(P<0.05).After treatment,the hepatitis B surface antigen(HBsAg)level and liver stiffness measurement(LSM)in the two groups were significantly lower,the diameter of spleen in the two groups was significantly smaller,and those in the study group changed more significantly than those in the control group(P<0.05).The incidence of adverse reactions during treatment in the study group was similar to that in the control group(14.81%vs.9.26%,P>0.05).Conclusion Ruangan Decoction combined with entecavir is effective and safe in the treatmen

关 键 词：软肝汤 恩替卡韦 乙型病毒性肝炎 肝硬化 腹水 肝功能 免疫功能 炎性因子 临床疗效 

分 类 号：R932[医药卫生—生药学] R285.6[医药卫生—药学]