扶正化瘀胶囊联合微生态制剂和恩替卡韦治疗乙型肝炎病毒感染失代偿期肝硬化的临床研究

目的:探讨扶正化瘀胶囊联合微生态制剂和恩替卡韦治疗乙型肝炎病毒(HBV)感染失代偿期肝硬化的临床效果。方法:选取2015年6月～2019年6月期间我院收治的HBV感染失代偿期肝硬化患者73例,根据随机数字表法分为对照组(n=36)和研究组(n=37),对照组患者予以微生态制剂和恩替卡韦治疗,研究组则在对照组的基础上联合扶正化瘀胶囊治疗,比较两组患者疗效、T淋巴细胞亚群、肝功能[天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)]以及肝纤维化指标[透明质酸(HA)、层黏连蛋白(LN)],记录两组乙肝表面e抗原(HBeAg)、乙肝病毒基因(HBV-DNA)转阴情况,记录两组不良反应发生情况。结果:研究组治疗6个月后的临床总有效率为91.89%(34/37),高于对照组的72.22%(26/36)(P0.05)。两组治疗6个月后AST、TBIL、HA、LN、CD8+~均下降,且研究组低于对照组(P0.05)。两组治疗6个月后CD4+~、CD4+~/CD8+~升高,且研究组高于对照组(P0.05)。两组治疗6个月后HBeAg、HBV-DNA转阴率比较无统计学差异(P0.05)。两组不良反应发生率对比未见统计学差异(P0.05)。结论:扶正化瘀胶囊联合微生态制剂和恩替卡韦治疗HBV感染失代偿期肝硬化疗效显著,虽在HbeAg、HBV-DNA转阴率方面未见明显改善,但可有效改善肝功能,减轻肝纤维化,提高机体免疫功能,且不增加不良反应发生率,安全性较好。

Clinical Study of Fuzheng Huayu Capsule Combined with Microecological Preparation and Entecavir in the Treatment of Decompensated Cirrhosis Due to Hepatitis B Virus Infection

ABSTRACT Objective: To investigate the clinical effect of Fuzheng Huayu capsule combined with microecological preparation and entecavir in the treatment of decompensated cirrhosis of hepatitis B virus (HBV) infection. Methods: 73 patients with decompensated cirrhosis of HBV infection who were admitted to our hospital from June 2015 to June 2019 were selected, they were divided into control group (n=36) and study group (n=37) according to the method of random number table. The control group was treated with microecological preparation and entecavir. The study group was treated with Fuzheng Huayu Capsule on the basis of the control group. The curative effect, T-lymphocyte subsea, liver function [aspartate aminotransferase (AST), total bilirubin (TBIL)] and liver fibrosis index [hyaluronic acid (HA), laminin (LN)] of the two groups were compared, the negative changes of hepatitis B surface e antigen (HBeAg) and hepatitis B virus gene (HBV-DNA) in the two groups were recorded, and the adverse reactions in the two groups were recorded. Results: The total clinical effective rate of the study group was 91.89% (34/37), which was higher than 72.22% (26/36) of the control group (P<0.05). AST, TBIL, HA, LN, CD8⁺ decreased in the two groups 6 months after treatment, and the level in the study group were lower than those in the control group (P<0.05). CD4⁺, CD4⁺/CD8⁺ increased in the two groups 6 months after treatment, and the study group were higher than those in the control group (P<0.05). There was no significant difference in the negative rate of HBeAg and HBV-DNA between the two groups (P>0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Fuzheng Huayu capsule combined with microecological preparation and entecavir is effective in the treatment of decompensated cirrhosis of HBV infection. Although there is no significant improvement in HBeAg and HBV-DNA negative rate, it can effectively improve the liver function, reduce liver fibrosis, improve the immune function of the body, and do not increase the incidence of adverse reactions.