CAJ | 학술논문

目的：探讨复方牛胎肝提取物片联合恩替卡韦片治疗慢性乙型肝炎患者的临床疗效。方法将48例慢性乙型肝炎患者随机分为治疗组24例，给予口服复方牛胎肝提取物片及恩替卡韦片；给予对照组24例口服恩替卡韦片，疗程均为48w。观察两组患者治疗前后肝功能、血清肝纤维化指标及肝穿刺活检组织病理学的变化情况。结果在治疗48w时，治疗组血清白蛋白水平为（41.0±2.9） g/L，显著高于对照组（36.2±2.2） g/L，P＜0.01；治疗组血清透明质酸（HA）、层粘蛋白（LN）和IV型胶原（IV-C）水平分别为（158.0±70.3） ng/ml、（83.6±29.9） ng/ml和（90.3±41.2） ng/ml，显著低于对照组（170.6±71.1） ng/ml、（107.5±33.7） ng/ml和（113.5±52.4） ng/ml，P均＜0.05；肝组织病理学检查显示治疗组患者肝脏炎症活动度及纤维化程度改善均优于对照组（P=0.041和P=0.044）。结论复方牛胎肝提取物片联合恩替卡韦片能显著改善慢性乙型肝炎患者肝脏炎症活动度及纤维化程度，促进白蛋白合成，疗效优于单用恩替卡韦治疗。
목적：탐토복방우태간제취물편연합은체잡위편치료만성을형간염환자적림상료효。방법장48례만성을형간염환자수궤분위치료조24례，급여구복복방우태간제취물편급은체잡위편；급여대조조24례구복은체잡위편，료정균위48w。관찰량조환자치료전후간공능、혈청간섬유화지표급간천자활검조직병이학적변화정황。결과재치료48w시，치료조혈청백단백수평위（41.0±2.9） g/L，현저고우대조조（36.2±2.2） g/L，P＜0.01；치료조혈청투명질산（HA）、층점단백（LN）화IV형효원（IV-C）수평분별위（158.0±70.3） ng/ml、（83.6±29.9） ng/ml화（90.3±41.2） ng/ml，현저저우대조조（170.6±71.1） ng/ml、（107.5±33.7） ng/ml화（113.5±52.4） ng/ml，P균＜0.05；간조직병이학검사현시치료조환자간장염증활동도급섬유화정도개선균우우대조조（P=0.041화P=0.044）。결론복방우태간제취물편연합은체잡위편능현저개선만성을형간염환자간장염증활동도급섬유화정도，촉진백단백합성，료효우우단용은체잡위치료。
Objective To investigate the effect of combined therapy of compound embryonic bovine liver extract and entecavir in patients with chronic hepatitis B. Methods Forty-eight patients with chronic hepatitis B were randomly divided into treatment group (n=24) and control group (n=24). Patients in treatment group were treated with compound embryonic bovine liver extract plus entecavir,and those in control group were treated with entecavir alone. The treatment lasted for 48 weeks and the liver function tests,serum hepatic fibrosis indexes and the histological activity index and fibrosis before and after treatment in the two groups were examined. Results At the end of 48 weeks of the treatment,serum albumin levels in patients in treatment group (41.0±2.9 g/L)were significantly higher than that in the controls(36.2±2.2 ) g/L,P<0.01;Serum hyaluronic acids (158.0±70.3)ng/ml, laminin (83.6±29.9) ng/mland collagen type IV (90.3±41.2) ng/mlin the treatment group were significantly lower than those in the controls (170.6±71.1) ng/ml,(107.5±33.7) ng/ml and (113.5±52.4) ng/ml,respectively,P<0.05);Histopathological examinations of the liver biopsies showed that the grades and stages of the liver injuries in treatment group were decreased significantly as compared with in control group(P<0.05). Conclusions Combined therapy of compound embryonic bovine liver extract and entecavir are better than entecavir alone in inhibiting liver inflammation and fibrosis in patients with chronic hepatitis B.