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目的:探讨慢性乙型肝炎肝纤维化采用恩替卡韦联合自拟血府逐瘀汤治疗的临床疗效。方法:将86例慢性乙型肝炎肝纤维化患者按照随机数字表随机分为分为观察组(n=43例)和对照组(n=43例),对照组给予口服恩替卡韦分散片治疗,观察组给予自拟血府逐瘀汤+恩替卡韦分散片治疗,疗程均为48周;观察两组患者治疗前后的临床症状体征改善情况、肝功能指标、肝纤维化相关指标以及肝脏影像学指标变化情况。结果:观察组治疗后临床症状体征改善情况优于对照组(P<0.05);观察组治疗后较对照组肝功能指标(ALT、AST、ALB、TBIL)改善程度显著要优(P<0.05);观察组治疗后较对照组肝纤维化指标改善程度显著要优(P<0.05);观察组治疗后较对照组门静脉的内径、脾脏厚度显著要小(P<0.05);观察组治疗后较对照组HBe Ag转阴率显著要高(P<0.05);结论:慢性乙型肝炎肝纤维化采取恩替卡韦联合自拟血府逐瘀汤治疗较单一恩替卡韦治疗的临床疗效更显著,优于值得临床推广。
Objective: To investigate the clinical efficacy of entecavir combined with Xuefu Zhuyu Decoction in treating chronic hepatitis B with liver fibrosis. Methods: Eighty-six patients with chronic hepatitis B liver fibrosis were randomly divided into observation group (n = 43) and control group (n = 43) according to random number table. The control group was treated with oral entecavir dispersible tablets The patients were given Xuefuzhuyutang + entecavir dispersible tablets for 48 weeks. The improvement of clinical symptoms and signs, liver function indexes, liver fibrosis related indexes and liver imaging indexes before and after treatment were observed in both groups . Results: The improvement of clinical symptoms and signs in observation group was better than that in control group (P <0.05). The improvement of liver function index (ALT, AST, ALB, TBIL) in observation group was significantly better than that in control group after treatment (P <0.05). After treatment, the diameter of portal vein and the spleen thickness of the observation group were significantly smaller than those of the control group (P <0.05). After the treatment, the observation group had better liver fibrosis index than the control group The HBeAg negative rate in the control group was significantly higher (P <0.05). Conclusion: The clinical efficacy of entecavir combined with Xuefu Zhuyu Decoction in the treatment of chronic hepatitis B was more significant than that of the single entecavir treatment, which was better than that of the clinical Promotion.