参芪益肝汤联合恩替卡韦对乙型肝炎肝硬化患者肝脏硬度及血清CK18水平的影响  

Effect of Shenqi Yigan Decoction Combined with Entecavir on Liver Hardness and Serum CK18 Levels in Patients with Hepatitis B Cirrhosis

作　　者：赵延恒 郝志州 ZHAO Yanheng;HAO Zhizhou(Infectious Diseases Department of General Hospital of Yima Coal Industry Group Co.,Ltd.,Yima Henan 472300,China)

机构地区：[1]义马煤业集团股份有限公司总医院感染性疾病科,河南义马472300

出　　处：《新中医》2025年第6期41-45,共5页New Chinese Medicine

摘　　要：目的:观察参芪益肝汤联合恩替卡韦对乙型肝炎肝硬化患者肝脏硬度及血清细胞角蛋白18(CK18)水平的影响。方法:将2022年6月—2023年6月义马煤业集团股份有限公司总医院收治的乙型肝炎肝硬化代偿期患者80例,按照随机数字表法分为对照组与观察组各40例,对照组给予恩替卡韦治疗,观察组在对照组基础上加用参芪益肝汤治疗。治疗6个月后,观察比较2组临床疗效、肝脏硬度、实验室指标[细胞角蛋白18(CK18)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、肝功能指标[总胆红素(TBil)、谷草转氨酶(AST)、谷丙转氨酶(ALT)]水平。结果:观察组总有效率为97.50%(39/40),对照组为80.00%(32/40),2组比较,差异有统计学意义(P<0.05)。治疗后,2组肝脏硬度均较治疗前降低(P<0.05),且观察组肝脏硬度低于对照组(P<0.05)。治疗后,2组血清CK18、IL-6、TNF-α水平均较治疗前降低(P<0.05),且观察组上述3项指标水平均低于对照组(P<0.05)。治疗后,2组血清TBil、AST、ALT水平均较治疗前降低(P<0.05),且观察组上述3项指标水平均低于对照组(P<0.05)。结论:参芪益肝汤联合恩替卡韦能够降低乙型肝炎肝硬化患者的肝脏硬度,有效抑制机体炎症反应,减轻肝脏损伤,改善肝功能,疗效优于单纯西药治疗。Objective:To observe the effect of Shenqi Yigan Decoction combined with Entecavir on liver hardness and serum cytokeratin 18(CK18)levels in patients with hepatitis B cirrhosis.Methods:A total of 80 cases of patients with compensated hepatitis B cirrhosis admitted to the General Hospital of Yima Coal Industry Group Co.,Ltd.from June 2022 to June 2023 were randomly divided into the control group and the observation group,with 40 patients in each group.The control group was treated with Entecavir,while the observation group was treated with Shenqi Yigan Decoction in addition to the treatment of the control group.After six months of treatment,the clinical efficacy,liver hardness,laboratory indicators[CK18,interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)],and liver function[total bilirubin(TBil),aspartate aminotransferase(AST),and alanine aminotransferase(ALT)]levels were observed and compared between the two groups.Results:The total effective rate was 97.50%(39/40)in the observation group,while that of 80.00%(32/40)in the control group,the difference being significant(P<0.05).After treatment,the liver hardness in both groups were decreased when compared with those before treatment(P<0.05),and the liver hardness in the observation group was lower than that in the control group(P<0.05).After treatment,the levels of serum CK18,IL-6,and TNF-αin both groups were decreased when compared with those before treatment(P<0.05),and the levels of these three indicators in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of serum TBil,AST,and ALT in both groups were decreased when compared with those before treatment,and the levels of these three indicators in the observation group were lower than those in the control group(P<0.05).Conclusion:The combination of Shenqi Yigan Decoction and Entecavir can effectively reduce the liver hardness of patients with hepatitis B cirrhosis,inhibit the body's inflammatory response,reduce liver damage,improve liver function,and has bett

关 键 词：肝硬化 乙型肝炎 参芪益肝汤 恩替卡韦 肝脏硬度 细胞角蛋白18 

分 类 号：R657.31[医药卫生—外科学]