[1]朱建凤.恩替卡韦和复方鳖甲软肝片联合治疗乙型肝炎肝硬化疗效观察[J].新乡医学院学报,2020,37(11):1084-1088.[doi:10.7683/xxyxyxb.2020.11.018]
　ZHU Jianfeng.Effect of entecavir combined with compound Biejia Ruangan tablet in the treatment of hepatitis B cirrhosis[J].Journal of Xinxiang Medical University,2020,37(11):1084-1088.[doi:10.7683/xxyxyxb.2020.11.018]
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恩替卡韦和复方鳖甲软肝片联合治疗乙型肝炎肝硬化疗效观察
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年11
页码:
1084-1088
栏目:
临床研究
出版日期:
2020-11-05

文章信息/Info

Title:
Effect of entecavir combined with compound Biejia Ruangan tablet in the treatment of hepatitis B cirrhosis
作者:
朱建凤
（西安市第八医院肝病科，陕西　西安　710061）
Author(s):
ZHU Jianfeng
（Department of Hepatology，the Eighth Hospital of Xi′an，Xi′an 710061，Shaanxi Province，China）
关键词:
恩替卡韦; 复方鳖甲软肝片; 肝炎; 肝硬化; 肝纤维化
Keywords:
entecavir; compound Biejia Ruangan tablet; hepatitis; hepatic cirrhosis; hepatic fibrosis
分类号:
R512.62
DOI:
10.7683/xxyxyxb.2020.11.018
文献标志码:
A
摘要:
目的　探讨恩替卡韦和复方鳖甲软肝片联合治疗乙型肝炎肝硬化的临床效果。方法　选择2016年1月至2018年1月西安市第八医院收治的160例乙型肝炎肝硬化患者为研究对象，根据治疗方法将患者分为观察组（n=78）和对照组（n=82）；对照组患者给予恩替卡韦治疗，观察组患者给予恩替卡韦和复方鳖甲软肝片联合治疗。2组患者分别于治疗前及治疗6个月后检测血清中丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、总胆红素（TBIL）、透明质酸（HA）、Ⅲ型前胶原（PC-Ⅲ）、Ⅳ型胶原（Col-Ⅳ）、层粘连蛋白（LN）及乙型肝炎病毒（HBV）DNA 水平，并使用超声诊断仪检测患者门静脉内径、脾静脉内径、脾脏厚度以及门静脉血流量，使用Fibroscan诊断仪检测患者肝脏硬度（LSM）；治疗6个月后评估2组患者的临床疗效，并观察患者治疗期间不良反应发生情况。结果　治疗前2组患者血清ALT、AST、TBIL、HBV DNA、HA、PC-Ⅲ、Col-Ⅳ及LN水平比较差异无统计学意义（P>0.05），2组患者治疗6个月后血清ALT、AST、TBIL、HBV DNA、HA、PC-Ⅲ、Col-Ⅳ及LN水平显著低于治疗前（P<0.05）；治疗6个月后，观察组患者血清ALT、AST、TBIL、HBV DNA、HA、PC-Ⅲ、Col-Ⅳ及LN水平显著低于对照组（P<0.05）。治疗前2组患者门静脉内径、脾静脉内径、脾脏厚度、门静脉血流量及LSM比较差异无统计学意义（P>0.05），2组患者治疗6个月后门静脉内径、脾静脉内径、脾脏厚度、门静脉血流量及LSM显著小于治疗前（P<0.05）；治疗6个月后，观察组患者门静脉内径、脾静脉内径、脾脏厚度、门静脉血流量及LSM显著小于对照组（P<0.05）。治疗6个月后，观察组和对照组患者总有效率分别为94.87%（74/78）、79.27%（65/82），观察组患者总有效率显著高于对照组（χ2=8.536，P<0.05）。治疗期间，观察组和对照组患者不良反应发生率为分别6.41%（5/78）、7.32%（6/82），2组患者不良反应发生率比较差异无统计学意义（χ2=0.051，P>0.05）。结论　恩替卡韦和复方鳖甲软肝片联合治疗可以有效抑制乙型肝炎肝硬化患者HBV DNA复制，减轻肝纤维化，改善肝功能。
Abstract:
Objective　To investigate the clinical effect of entecavir combined with compound Biejia Ruangan tablet in the treatment of hepatitis B cirrhosis.Methods　A total of 160 patients with hepatitis B cirrhosis admitted to the Eighth Hospital of Xi′an from January 2016 to January 2018 were selected as the research subjects，and the patients were divided into observation group （n=78） and control group （n=82） according to the treatment methods.The patients in the control group were treated with entecavir，while the patients in the observation group were treated with entecavir and compound Biejia Ruangan tablet.Before and after treatment for 6 months，the levels of serum alanine transarninase （ALT），aspartate aminotransferase （AST），total bilirubin （TBIL），hyaluronic acid （HA），procollagen type Ⅲ （PC-Ⅲ），collagen type Ⅳ （Col-Ⅳ），laminin （LN） and hepatitis B virus （HBV） DNA were detected；the internal diameter of portal vein，the internal diameter of splenic vein，the thickness of spleen and the portal venous blood flow were measured by ultrasonic diagnostic equipment；and the liver stiffness measurement （LSM） was measured by Fibroscan instrument.The clinical effect of the patients in the two groups was evaluated after 6 months of treatment，and the incidence of adverse reactions was observed.Results　There was no significant difference in serum ALT，AST，TBIL，HBV DNA，HA，PC-Ⅲ，Col-Ⅳ and LN levels between the two groups before treatment （P>0.05）.The levels of serum ALT，AST，TBIL，HBV DNA，HA，PC-Ⅲ，Col-Ⅳ and LN after 6 months of treatment were signi-ficantly lower than those before treatment in the two groups （P<0.05）.The levels of serum ALT，AST，TBIL，HBV DNA，HA，PC-Ⅲ，Col-Ⅳ and LN in the observation group were significantly lower than those in the control group after 6 months of treatment （P<0.05）.There was no significant difference in the internal diameter of portal vein，the internal diameter of splenic vein，the thickness of spleen，the portal venous blood flow and LSM between the two groups before treatment （P>0.05）.The internal diameter of portal vein，the internal diameter of splenic vein，the thickness of spleen，the portal venous blood flow and LSM after 6 months of treatment were significantly less than those before treatment in the two groups （P<0.05）.The internal diameter of portal vein，the internal diameter of splenic vein，the thickness of spleen，the portal venous blood flow and LSM in the observation group were significantly less than those in the control group after 6 months of treatment （P<0.05）.After 6 months of treatment，the total effective rate in the observation group and the control group was 94.87% （74/78） and 79.27% （65/82），respectively.The total effective rate in the observation group was significantly higher than that in the control group （χ2=8.536，P<0.05）.The incidence of adverse reactions in the observation group and the control group was 6.41% （5/78） and 7.32% （6/82），respectively during the treatment.There was no significant difference in the incidence of adverse reactions between the two groups （χ2=0.051，P>0.05）.Conclusion　Entecavir combined with compound Biejia Ruangan tablets can effectively inhibit HBV DNA replication，reduce liver fibrosis and improve liver function in patients with hepatitis B cirrhosis.

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更新日期/Last Update: 2020-11-05