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目的探讨恩替卡韦联合正肝化瘀方治疗慢性乙型肝炎后肝纤维化的临床疗效。方法 138例慢性乙型肝炎患者,根据治疗方法不同分为观察组和对照组,每组69例。对照组患者予以恩替卡韦进行治疗,观察组在对照组的基础上予以正肝化瘀方进行治疗,观察两组患者治疗前后肝功能指标和肝纤维化指标变化。结果两组患者治疗后丙氨酸氨基转移酶(ALT)、天门冬氨酸转氨酶(AST)、总胆红素(TBIL)水平均低于治疗前,差异有统计学意义(P<0.05);观察组治疗后ALT、AST、TBIL水平分别为(48.87±15.13)U/L、(32.48±8.27)U/L、(14.46±2.34)μmol/L,均低于对照组的(65.48±18.42)U/L、(44.61±12.46)U/L、(26.56±3.12)μmol/L,差异有统计学意义(P<0.05)。两组患者治疗后血清透明质酸(HA)、层粘连蛋白(LN)、Ⅳ型胶原(CⅣ)、Ⅲ型前胶原(PCⅢ)水平均低于治疗前,且观察组明显低于对照组,差异有统计学意义(P<0.05)。结论恩替卡韦联合正肝化瘀方对慢性乙型肝炎肝功能和肝纤维化的改善效果显著,临床应用前景广阔。
Objective To investigate the clinical efficacy of entecavir plus Zhengganhuayu Recipe in treating liver fibrosis after chronic hepatitis B. Methods 138 cases of chronic hepatitis B patients, divided into observation group and control group according to the different treatment methods, each group of 69 cases. Patients in the control group were treated with entecavir. The observation group was treated with Zheng Gan Huayu Decoction on the basis of the control group. The changes of liver function index and liver fibrosis index before and after treatment were observed in both groups. Results The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBIL) after treatment in both groups were significantly lower than those before treatment (P <0.05). The levels of ALT, AST and TBIL in observation group were (48.87 ± 15.13) U / L, (32.48 ± 8.27) U / L and (14.46 ± 2.34) μmol / L respectively, which were all lower than those in control group (65.48 ± 18.42) U / L, (44.61 ± 12.46) U / L, (26.56 ± 3.12) μmol / L respectively. There was significant difference between the two groups (P <0.05). The levels of serum hyaluronic acid (HA), laminin (LN), collagen Ⅳ (Ⅳ) and procollagen Ⅲ (Ⅲ) in the two groups after treatment were lower than those before treatment, and the levels in the observation group were significantly lower than those in the control group The difference was statistically significant (P <0.05). Conclusion The effect of entecavir plus Zhengganhuayu Recipe on improving liver function and liver fibrosis in patients with chronic hepatitis B is significant. The clinical application is promising.