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目的探讨中药肝康颗粒与恩替卡韦联合治疗慢性乙型肝炎(乙肝)的临床疗效。方法选取2012年1月—2013年1月收治的慢性乙肝患者118例,随机分为治疗组(A组)和对照组(B组),每组59例患者。对照组给予口服恩替卡韦,治疗组在对照组的基础上加用中药肝康颗粒联合治疗。结果治疗前两组患者的肝纤维化评价指标血清透明质酸(HA)、层黏连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(CⅣ)比较,差异无统计学意义(P>0.05)。治疗后两组患者的HA、LN、PCⅢ及CⅣ比较,差异有统计学意义(P<0.05)。治疗48周后两组患者的血清谷丙转氨酶复常率比较,差异有统计学意义(P<0.05);乙肝病毒DNA转阴率、慢性乙肝e抗原转阴率及慢性乙肝e抗体转阳率比较,差异无统计学意义(P>0.05)。治疗48周后分别对两组45例患者进行肝活体组织检查,对肝纤维化改善的情况对比发现,A组患者肝纤维化较B组患者改善明显,差异有统计学意义(P<0.05)。结论采用中药肝康颗粒联合抗病毒药物恩替卡韦治疗慢性乙肝,其在保肝、改善肝纤维化的临床效果优于单用抗病毒药物恩替卡韦,联合用药的方法值得在临床上推广。
Objective To investigate the clinical efficacy of Gan Kang Granule combined with entecavir in the treatment of chronic hepatitis B (hepatitis B). Methods 118 patients with chronic hepatitis B who were admitted from January 2012 to January 2013 were randomly divided into treatment group (A group) and control group (B group), 59 patients in each group. Control group was given oral entecavir, the treatment group in the control group based on the use of traditional Chinese medicine Gan Kang particles combined treatment. Results There was no significant difference in the indexes of liver fibrosis between the two groups before treatment (HA, LN, PCⅢ, C Ⅳ) P> 0.05). After treatment, HA, LN, PCⅢ and CⅣ in the two groups were significantly different (P <0.05). After 48 weeks of treatment, the alanine aminotransferase normalization rate of two groups of patients was significantly different (P <0.05); HBV DNA negative rate, chronic hepatitis B e antigen negative rate and chronic hepatitis B e positive rate The difference was not statistically significant (P> 0.05). Forty-eight weeks after treatment, liver biopsies were performed on 45 patients in both groups. Comparing the improvement of liver fibrosis, the liver fibrosis in group A was significantly improved compared with that in group B (P <0.05) . Conclusions The clinical effect of using Gan Kang Granule combined with antiviral drug entecavir in the treatment of chronic hepatitis B is better than that of single antiviral drug entecavir in liver protection and liver fibrosis. The combination therapy is worthy of clinical promotion.