实用肝脏病杂志
實用肝髒病雜誌
실용간장병잡지
Journal of Practical Hepatology
2015年
6期
616-619
,共4页
李国焕%舒盼%张均%胡萌%李玉龙
李國煥%舒盼%張均%鬍萌%李玉龍
리국환%서반%장균%호맹%리옥룡
肝硬化%慢性乙型肝炎%恩替卡韦%扶正化瘀胶囊%治疗
肝硬化%慢性乙型肝炎%恩替卡韋%扶正化瘀膠囊%治療
간경화%만성을형간염%은체잡위%부정화어효낭%치료
Cirrhosis%Chronic hepatitis B%Entecavir%Fuzhenghuayu capsules%Efficacy
目的:观察恩替卡韦联合扶正化瘀胶囊治疗活动性肝硬化患者的疗效。方法60例活动性乙型肝炎肝硬化患者被随机分为观察组30例和对照组30例,两组均给予常规治疗。给予对照组患者恩替卡韦片治疗24 w,给予观察组患者恩替卡韦联合扶正化瘀胶囊治疗,观察并比较两组血清肝纤维化指标和肝功能变化。结果治疗前对照组患者血清透明质酸为(320.4±196) ng/ml,层黏连蛋白为(180.9±80) ng/ml,Ⅲ型前胶胶原为(261.2±132) ng/ml、Ⅳ型胶原为(204.1±78.1) ng/m,谷丙转氨酶为(169.87±13.32) U/L、白蛋白为(34.05±6.94) U/L、总胆红素为(48.89±11.03)μmol/L,门静脉直径为(12.9±1.1)mm,脾脏长度为(12.9±1.1)mm、脾脏厚度为(48.6±4.7)mm,观察组透明质酸为(334.7±119.8) ng/ml,层黏连蛋白为(183.2±79.6) ng/ml,Ⅲ型前胶胶原为(252.5±139.8) ng/ml、Ⅳ型胶原为(203.3±74.1) ng/m,谷丙转氨酶为(171.53±11.21) U/L、白蛋白为(33.46±7.53) U/L、总胆红素为(49.33±10.1)μmol/L,门静脉直径为(13.1±0.7)mm,脾脏长度为(122.1±3.9)mm、脾脏厚度为(48.9±4.2)mm,两组无显著性统计学差异;治疗后,对照组透明质酸为(205.2±49.6) ng/ml,层黏连蛋白为(149.8±64.3) ng/ml,Ⅲ型前胶胶原为(192.7±99.8) ng/ml、Ⅳ型胶原为(159.2±42.5) ng/m,谷丙转氨酶为(54.89±6.65) U/L、白蛋白为(35.59±7.2) U/L、总胆红素为(20.89±9.65)μmol/L,门静脉直径为(11.7±0.85)mm,脾脏长度为(117.3±2.9)mm、脾脏厚度为(46.8±3.6) mm,观察组透明质酸为(158.2±79.1) ng/ml,层黏连蛋白为(104.3±59.7) ng/ml,Ⅲ型前胶胶原为(140.2±76.4) ng/ml、Ⅳ型胶原为(111.4±56.8) ng/m,谷丙转氨酶为(24.37±7.33) U/L、白蛋白为(41.02±6.3) U/L、总胆红素为(10.32±8.03)μmol/L,门静脉直径为(10.2±0.5)mm,脾脏长度为(109.4±3.1)mm、脾脏厚度为(44.4±2.0)mm,两组间具有显著性统计学差异(P<0.05);治疗48结束时,观察组患者血清HBV DNA阴转率为83.3%,明显高于对照组治疗后的40%(P<0.05)。结论恩替卡韦联合扶正化瘀胶囊治疗肝硬化患者,其疗效明显优于单用恩替卡韦。
目的:觀察恩替卡韋聯閤扶正化瘀膠囊治療活動性肝硬化患者的療效。方法60例活動性乙型肝炎肝硬化患者被隨機分為觀察組30例和對照組30例,兩組均給予常規治療。給予對照組患者恩替卡韋片治療24 w,給予觀察組患者恩替卡韋聯閤扶正化瘀膠囊治療,觀察併比較兩組血清肝纖維化指標和肝功能變化。結果治療前對照組患者血清透明質痠為(320.4±196) ng/ml,層黏連蛋白為(180.9±80) ng/ml,Ⅲ型前膠膠原為(261.2±132) ng/ml、Ⅳ型膠原為(204.1±78.1) ng/m,穀丙轉氨酶為(169.87±13.32) U/L、白蛋白為(34.05±6.94) U/L、總膽紅素為(48.89±11.03)μmol/L,門靜脈直徑為(12.9±1.1)mm,脾髒長度為(12.9±1.1)mm、脾髒厚度為(48.6±4.7)mm,觀察組透明質痠為(334.7±119.8) ng/ml,層黏連蛋白為(183.2±79.6) ng/ml,Ⅲ型前膠膠原為(252.5±139.8) ng/ml、Ⅳ型膠原為(203.3±74.1) ng/m,穀丙轉氨酶為(171.53±11.21) U/L、白蛋白為(33.46±7.53) U/L、總膽紅素為(49.33±10.1)μmol/L,門靜脈直徑為(13.1±0.7)mm,脾髒長度為(122.1±3.9)mm、脾髒厚度為(48.9±4.2)mm,兩組無顯著性統計學差異;治療後,對照組透明質痠為(205.2±49.6) ng/ml,層黏連蛋白為(149.8±64.3) ng/ml,Ⅲ型前膠膠原為(192.7±99.8) ng/ml、Ⅳ型膠原為(159.2±42.5) ng/m,穀丙轉氨酶為(54.89±6.65) U/L、白蛋白為(35.59±7.2) U/L、總膽紅素為(20.89±9.65)μmol/L,門靜脈直徑為(11.7±0.85)mm,脾髒長度為(117.3±2.9)mm、脾髒厚度為(46.8±3.6) mm,觀察組透明質痠為(158.2±79.1) ng/ml,層黏連蛋白為(104.3±59.7) ng/ml,Ⅲ型前膠膠原為(140.2±76.4) ng/ml、Ⅳ型膠原為(111.4±56.8) ng/m,穀丙轉氨酶為(24.37±7.33) U/L、白蛋白為(41.02±6.3) U/L、總膽紅素為(10.32±8.03)μmol/L,門靜脈直徑為(10.2±0.5)mm,脾髒長度為(109.4±3.1)mm、脾髒厚度為(44.4±2.0)mm,兩組間具有顯著性統計學差異(P<0.05);治療48結束時,觀察組患者血清HBV DNA陰轉率為83.3%,明顯高于對照組治療後的40%(P<0.05)。結論恩替卡韋聯閤扶正化瘀膠囊治療肝硬化患者,其療效明顯優于單用恩替卡韋。
목적:관찰은체잡위연합부정화어효낭치료활동성간경화환자적료효。방법60례활동성을형간염간경화환자피수궤분위관찰조30례화대조조30례,량조균급여상규치료。급여대조조환자은체잡위편치료24 w,급여관찰조환자은체잡위연합부정화어효낭치료,관찰병비교량조혈청간섬유화지표화간공능변화。결과치료전대조조환자혈청투명질산위(320.4±196) ng/ml,층점련단백위(180.9±80) ng/ml,Ⅲ형전효효원위(261.2±132) ng/ml、Ⅳ형효원위(204.1±78.1) ng/m,곡병전안매위(169.87±13.32) U/L、백단백위(34.05±6.94) U/L、총담홍소위(48.89±11.03)μmol/L,문정맥직경위(12.9±1.1)mm,비장장도위(12.9±1.1)mm、비장후도위(48.6±4.7)mm,관찰조투명질산위(334.7±119.8) ng/ml,층점련단백위(183.2±79.6) ng/ml,Ⅲ형전효효원위(252.5±139.8) ng/ml、Ⅳ형효원위(203.3±74.1) ng/m,곡병전안매위(171.53±11.21) U/L、백단백위(33.46±7.53) U/L、총담홍소위(49.33±10.1)μmol/L,문정맥직경위(13.1±0.7)mm,비장장도위(122.1±3.9)mm、비장후도위(48.9±4.2)mm,량조무현저성통계학차이;치료후,대조조투명질산위(205.2±49.6) ng/ml,층점련단백위(149.8±64.3) ng/ml,Ⅲ형전효효원위(192.7±99.8) ng/ml、Ⅳ형효원위(159.2±42.5) ng/m,곡병전안매위(54.89±6.65) U/L、백단백위(35.59±7.2) U/L、총담홍소위(20.89±9.65)μmol/L,문정맥직경위(11.7±0.85)mm,비장장도위(117.3±2.9)mm、비장후도위(46.8±3.6) mm,관찰조투명질산위(158.2±79.1) ng/ml,층점련단백위(104.3±59.7) ng/ml,Ⅲ형전효효원위(140.2±76.4) ng/ml、Ⅳ형효원위(111.4±56.8) ng/m,곡병전안매위(24.37±7.33) U/L、백단백위(41.02±6.3) U/L、총담홍소위(10.32±8.03)μmol/L,문정맥직경위(10.2±0.5)mm,비장장도위(109.4±3.1)mm、비장후도위(44.4±2.0)mm,량조간구유현저성통계학차이(P<0.05);치료48결속시,관찰조환자혈청HBV DNA음전솔위83.3%,명현고우대조조치료후적40%(P<0.05)。결론은체잡위연합부정화어효낭치료간경화환자,기료효명현우우단용은체잡위。
Objective To explore the therapeutic efficacy of entecavir combined with Fuzhenghuayu capsules in the treatment of patients with hepatitis B cirrhosis. Methods 60 patients with active hepatitis B related cirrhosis were randomly divided into observation group (n=30) and control group (n=30). At the base of conventional therapy,patients in control group was given only entecavir,while in observation group was given entecavir combined with Fuzhenghuayu capsules,and both for 24 weeks. Serum indicators of hepatic fibrosis and liver function were recorded and analyzed. Results Serum hyaluronic acid (HA),laminin (LN),procollagen type III (PCⅢ,collagen-Ⅳ(Ⅳ-C),alanine aminotransferase (ALT),albumin (ALB),total bilirubin(TBIL),portal vein’s diameter,spleen length and spleen thickness in observation group and control group before the treatment had no significant differences [HA(334.7±119.8) ng/ml vs. (320.4±196) ng/ml;LN (183.2±79.6) ng/ml vs. (180.9±80) ng/ml;PC Ⅲ(252.5±139.8) ng/ml vs. (261.2±132) ng/ml;IV-C (203.3±74.1) ng/ml vs. (204.1±78.1) ng/ml;ALT (171.53±11.21) U/L vs. (169.87±13.32) U/L;ALB (33.46±7.53) g/L vs. (34.05±6.94) g/L;TBIL (49.33±10.1)μmol/L vs.(48.89±11.03)μmol/L;portal vein’s diameter (13.1±0.7) mm vs. (12.9±1.1) mm;spleen’s length (122.1±3.9) mm vs. (123.4±2.5) mm;spleen’s thickness (48.9±4.2) mm vs. (48.6±4.7) mm;P>0.05 for all];After the treatment,the above-mentioned indicators in the two groups were statistically different [HA (158.2±79.1) ng/ml vs. (205.2±49.6) ng/ml;LN (104.3±59.7) ng/ml vs. (149.8±64.3) ng/ml;PC Ⅲ(140.2±76.4) ng/ml vs. (192.7±99.8) ng/ml;IV-C (111.4±56.8) ng/ml vs.(159.2±42.5) ng/ml;ALT(24.37±7.33) U/L vs. (54.89±6.65) U/L;ALB (41.02±6.3) g/L vs. (35.59±7.2) g/L;TBIL (10.32±8.03)μmol/L vs. (20.89±9.65)μmol/L;portal vein’s diameter (10.2±0.5) mm vs. (11.7±0.85) mm;spleen length (109.4±3.1) mm vs. (117.3±2.9) mm;spleen thickness(44.4±2.0) mm vs. (46.8±3.6) mm;P<0.05 for all];The rate of serum HBV DNA loss in observation group after 24-week treatment was 83.3%,significantly higher than 40.0% in control group (P<0.05). Conclusions The combination of entecavir and Fuzhenghuayu capsules exerts better therapeutic efficacy in the treatment of patients with liver cirrhosis.