恩替卡韦联合扶正化瘀胶囊治疗慢性乙型肝炎肝纤维化73例疗效观察

摘要

Objective To observe the efficacy of entecavir combined with Fuzheng Huayu capsule in treatment of liver fibrosis in chronic hepatitis B. Methods 73 patients with liver fibrosis were randomly divided into combination group and control group. Patients in the control group received entecavir treatment alone, while patients in the combination group combined with Fuzheng Huayu capsule. All patients received 12 months treatment. Clinical manifestations, liver function, HBV-M, HBV DNA, liver fibrosis indexes and color ultrasound images were measured before and after treatment and then compared between two groups. Results The symptoms of fatigue, anorexia and liver pain were significantly improved in the combination group than those in the control group ( P < 0. 05 ) , the ALT decreased and HBeAg disappeared in the combination group were much better than those in the control group ( P < 0. 05 ) , but the AST, TBIL, ALB, abdominal distension and HBV DNA disappeared were no statistical difference between two groups ( P >0. 05) . The liver fibrosis indexes in the combination group were much lower than those in the control group ( P < 0.05) , the diameter of portal vein and thickness of the spleen were significantly reduced compared with the control group ( P <0. 05) . Conclusion Combined treatment of liver fibrosis in chronic hepatitis B patients with entecavir and Fuzheng Huayu capsule was desirable.%目的 观察恩替卡韦联合扶正化瘀胶囊治疗慢性乙型肝炎肝纤维化的临床疗效.方法 选择73例慢性乙型肝炎肝纤维化患者,随机分为两组.联合组采用恩替卡韦联合扶正化瘀胶囊治疗,对照组采用单一恩替卡韦治疗,疗程12个月.观察两组患者治疗前后的症状体征、肝功能、HBV-M、HBV DNA、肝纤维化指标及肝脏影像学等变化.结果 联合组患者治疗后乏力、纳差及肝区痛改善情况明显高于对照组(P<0.05);ALT下降及HBeAg转阴情况均优于对照组(P<0.05);但治疗后两组AST、TBIL、ALB、HBV DNA转阴率及腹胀情况比较差异无统计学意义(P>0.05);联合组肝纤维化指标降低较对照组明显(P<0.05);联合组门静脉内径及脾脏厚度缩小也优于对照组(P<0.05).结论 恩替卡韦联合扶正化瘀胶囊治疗慢性乙型肝炎肝纤维化具有较好的临床效果.