摘要
目的:探讨恩替卡韦与通络软坚胶囊治疗乙肝后肝纤维化患者临床疗效,并观察其对患者血清学指标和肝功能及肝纤维化的影响.方法:收集2015年1月至2017年1月收治的120例乙肝后肝纤维化患者作为研究对象,采用简单随机数表法分为对照组和观察组各60例,两组患者均给予基础治疗,包括维生素类药物、甘草酸二铵肠溶胶囊等,在此基础上,对照组患者加用恩替卡韦片口服;观察组患者在对照组治疗基础上加用通络软坚胶囊.两组均6个月1疗程,治疗2个疗程.观测和评价两组患者治疗前、后血清血清基质金属蛋白酶-13(MMP-13)、肿瘤坏死因子α(TNF-α)、转化生长因子-β1(TGF-β1)、国际标准化比值(INR)、终末期肝病模型评分(MELD)变化.对比治疗前、后两组患者肝功能指标、肝纤维化指标的变化,观察记录两组临床疗效及不良反应发生情况,对其安全性进行评价.结果:治疗2个疗程后,观察组患者临床治疗总有效率为95.00%(57/60),明显高于对照组的81.67%(49/60),差异有统计学意义(P<0.01).两组血清学各项炎性指标(MMP-13、TNF-α、TGF-β1)、肝功能指标(ALT、GGT、TB)、INR及MELD评分较治疗前明显下降,且观察组各项指标改善程度较对照组更显著,差异有统计意义(P<0.01).观察组患者的肝纤维化指标下降程度明显优于对照组(P<0.01).治疗期间两组患者均未见严重性不良反应发生.结论:恩替卡韦片联合通络软坚胶囊治疗乙肝后肝纤维化患者具有明显疗效,可显著改善患者肝功能及肝纤维化指标,且较安全.
Objective:To explore the clinical effect of entecavir and Tongluo Ruanjian capsule in the treatment of liver fibrosis after hepatitis B,and to observe the influence of entecavir and Tongluo Ruanjian Capsule on serum indexes,liver function and liver fibrosis.Methods:From January 2015 to January 2017,120 patients with liver fibrosis after hepatitis B were collected as the study object,and divided into control group and observation group with simple random number table method,60 cases in each group.Both groups were given basic treatment,including vitamin,diammonium glycyrrhizinate enteric coated capsules,etc.On this basis,the patients in the control group were additionally administered with entecavir tablets;the patients in the observation group were additionally administered with Tongluo Ruanjian capsule.Both groups were treated for 6 months and 2 courses.The changes of serum matrix metalloproteinase-13(MMP-13),tumor necrosis factorα(TNF-α),transforming growth factorβ1(TGF-β1),international standard ratio(INR)and end-stage liver disease model score(MELD)were observed and evaluated before and after treatment.The changes of liver function indexes and liver fibrosis indexes were compared before and after treatment.The clinical efficacy and adverse reactions of the two groups were observed and recorded,and the safety of the two groups was evaluated.Results:After two courses of treatment,the total effective rate of clinical treatment in the observation group was 95.00%(57/60),significantly higher than 81.67%(49/60)in the control group,and the difference was statistically significant(P<0.01).The serum inflammatory indexes(MMP-13,TNF-α,TGF-β1),liver function indexes(ALT,GGT,TB),INR and MELD scores in the two groups were significantly lower than those before treatment,and the improvement degree of each index in the observation group was more significant than that in the control group,with statistical significance(P<0.01).The index of liver fibrosis in the observation group was significantly lower than that in the con
作者
沈丽贤
王晓玲
李惠文
SHEN Lixian;WANG Xiaoling;LI Huiwen(Hebei Hepatopathy Hospital of Traditional Chinese Medicine,Hebei Shijiazhuang 050800,China)
出处
《河北医学》
CAS
2020年第7期1220-1225,共6页
Hebei Medicine
基金
河北省中医药管理局科学技术研究计划课题,(编号:2018201)。
关键词
乙肝后肝纤维化
恩替卡韦
通络软坚胶囊
肝功能
Hepatitis B after liver cirrhosis
Entecavir
Tongluo
Ruanjian capsule
Liver function
