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目的探讨恩替卡韦联合复方鳖甲软肝片治疗慢性乙型肝炎肝纤维化的临床疗效。方法选取宁夏回族自治区人民医院2015年1月—2016年4月收治的慢性乙型肝炎肝纤维化患者76例,根据随机数字表法分为单一治疗组与联合治疗组,各38例。单一治疗组采用单纯恩替卡韦治疗,联合治疗组采用恩替卡韦联合复方鳖甲软肝片治疗,两组患者均治疗48周。比较两组患者临床疗效、干预前后生化指标[血清Ⅲ型前胶原氨基末端肽(PIIINP)、Ⅳ型前胶原羧基端肽(CIV)、层黏连蛋白(LN)、透明质酸(HA)]、乙型肝炎病毒基因(HBV-DNA)转阴率、乙型肝炎e抗原(HBeAg)血清学转换率、HBeAg血清学转换率,观察两组患者不良反应发生情况。结果联合治疗组治疗总有效率高于单一治疗组(P<0.05)。干预前两组患者生化指标比较,差异无统计学意义(P>0.05);干预后联合治疗组生化指标优于单一治疗组(P<0.05)。联合治疗组HBV-DNA转阴率、HBeAg血清学转换率高于单一治疗组(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论恩替卡韦联合复方鳖甲软肝片治疗慢性乙型肝炎肝纤维化的临床疗效确切,可有效促进HBeAg血清学转换和HBV-DNA转阴,改善肝纤维化症状,减轻患者临床症状,安全性高。
Objective To investigate the clinical efficacy of entecavir combined with Biejia Ruangan Tablet in the treatment of chronic hepatitis B liver fibrosis. Methods 76 patients with chronic hepatitis B liver fibrosis admitted from January 2015 to April 2016 in People’s Hospital of Ningxia Hui Autonomous Region were divided into single treatment group and combined treatment group according to random number table method, 38 cases in each group. The single treatment group was treated with simple entecavir, the combination therapy group was treated with entecavir and Fufang Biejia Ruangan Tablet, and both groups were treated for 48 weeks. The clinical curative effect of the two groups were compared. Before and after the intervention, the biochemical indexes [serum type Ⅲ PIIINP, type IV procollagen C, laminin, , HBV-DNA negative rate, HBeAg seroconversion rate and HBeAg seroconversion rate, and the incidence of adverse reactions in both groups were observed. Results The total effective rate of combination therapy group was higher than that of single therapy group (P <0.05). Before intervention, there was no significant difference in biochemical indexes between the two groups (P> 0.05). The biochemical indexes of combined treatment group were better than single treatment group after intervention (P <0.05). HBV-DNA negative rate and HBeAg seroconversion rate in combination therapy group were higher than those in single therapy group (P <0.05). Two groups of patients with adverse reactions, the difference was not statistically significant (P> 0.05). Conclusion Entecavir combined with Fufang Biejia Ruangan Tablet in the treatment of chronic hepatitis B liver fibrosis clinical curative effect, can effectively promote the HBeAg seroconversion and HBV-DNA negative, improve liver fibrosis symptoms, reduce the patient’s clinical symptoms, high safety .