恩替卡韦联合扶正化瘀胶囊治疗肝郁血瘀型慢性乙型肝炎疗效观察
Clinical Effect of Entecavir Combined with Fuzheng Huayu Capsule in Treatment of Chronic Hepatitis B with Stagnation of Liver Qi and Blood Stasis
  
DOI:
中文关键词:  慢性乙型肝炎  肝郁血瘀型  恩替卡韦  扶正化瘀胶囊
英文关键词:Chronic hepatitis B  Stagnation of liver Qi and blood stasis  Entecavir  Fuzheng Huayu Capsule
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作者单位
刘 雯,张贤兵,李福华,陈 萍 安徽省阜阳市第二人民医院肝病科安徽 阜阳 236015 
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中文摘要:
      目的 观察恩替卡韦联合扶正化瘀胶囊治疗肝郁血瘀型慢性乙型肝炎的临床疗效。方法 将60例肝郁血瘀型慢性乙型肝炎患者随机分为对照组和观察组,每组30例;在常规保肝及支持治疗的基础上,对照组仅予恩替卡韦治疗,观察组在对照组治疗基础上联合扶正化瘀胶囊治疗;比较治疗前和治疗后4、12、24、48周末两组患者血清乙型肝炎病毒(hepatitis B virus,HBV)DNA水平、乙型肝炎病毒e抗原(hepatitis B e antigen,HBeAg)定量和肝功能[丙氨酸氨基转移酶(alanine aminotransferase, ALT)、总胆红素(totol bilirubin,TBIL)]、肝脏瞬时弹性变化情况。结果 治疗4周末,观察组患者血清HBV-DNA转阴率显著高于对照组(P<0.05);治疗48周后,观察组HBeAg转阴率显著高于对照组(P<0.05)。治疗4周末,两组患者血清ALT、TBIL水平均较治疗前显著降低(P<0.05);治疗12周末,两组患者ALT、TBIL水平均较治疗4周末显著降低(P<0.05);治疗24周末与治疗48周末,两组ALT、TBIL水平比较,差异均无统计学意义(P>0.05)。观察组治疗4周末血清ALT、TBIL水平,治疗12、24周末TBIL水平较对照组降低更为明显(P<0.05)。治疗48周末,两组患者肝脏瞬时弹性均显著降低(P<0.05),观察组肝脏瞬时弹性指标降低程度显著大于对照组(P<0.05)。结论 恩替卡韦联合扶正化瘀胶囊治疗有助于提高肝郁血瘀型慢性乙型肝炎患者HBeAg转阴率、HBV-DNA快速应答率,并对肝功能改善和抗肝纤维化均有较好作用。
英文摘要:
      Objective To investigate the clinical effect of entecavir combined with Fuzheng Huayu Capsule in the treatment of chronic hepatitis B (CHB) with stagnation of liver Qi and blood stasis. Methods A total of 60 CHB patients with stagnation of liver Qi and blood stasis were randomly divided into observation group and control group, with 30 patients in each group. The patients in the control group were given routine liver-protecting therapy, supportive care, and entecavir, and those in the observation group were given Fuzheng Huayu Capsule in addition to the treatment in the control group.The two groups were compared in terms of serum hepatitis B virus (HBV)-DNA level,HBeAg quantification,liver function parameters [alanine aminotransferase (ALT) and total bilirubin (TBil)],and transient liver elasticity before treatment and after 4,12,24,and 48 weeks of treatment.Results At the end of week 4 of treatment, the observation group had a significantly higher HBV-DNA clearance rate than the control group (P<0.05), and after 48 weeks of treatment, the observation group had a significantly higher HBeAg clearance rate than the control group (P<0.05).Both groups had significant reductions in the serum levels of ALT and TBil from before treatment to the end of week 4 and then to the end of week 12 (P<0.05).There were no significant differences in the serum levels of ALT and TBil between the two groups at the end of weeks 24 and 48 of treatment (P>0.05).Compared with the control group, the observation group had significantly greater reductions in the serum levels of ALT and TBil at the end of week 4 of treatment,as well as a significantly greater reduction in the serum level of TBil at the end of weeks 12 and 24 of treatment (P<0.05).At the end of week 48 of treatment, both groups had a significant reduction in transient liver elasticity (P<0.05), and the observation group had a significantly greater reduction than the control group (P<0.05). Conclusion In CHB patients with stagnation of liver Qi and blood stasis, entecavir combined with Fuzheng Huayu Capsule helps to improve HBeAg clearance rate and HBV-DNA rapid response rate and has a good effect in improving liver function and preventing liver fibrosis.
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