复方鳖甲软肝片联合恩替卡韦片对慢性乙型肝炎瘀血阻络证型患者肝功能及胆红素的影响

发布时间：2018-02-16 18:49

  本文关键词： 慢性乙型肝炎 瘀血阻络证 复方鳖甲软肝片 恩替卡韦片 肝功能 肝纤维化 胆红素　出处：《中国药房》2017年14期 　论文类型：期刊论文

【摘要】：目的:观察复方鳖甲软肝片联合恩替卡韦片对慢性乙型肝炎瘀血阻络证型患者肝功能及胆红素的影响。方法:选取2015年1-12月内江市第二人民医院、西南医科大学附属医院、宜宾市第一人民医院收治的110例慢性乙型肝炎瘀血阻络证型患者,按分层区组随机方法分为对照组和观察组,各55例。对照组患者给予恩替卡韦片0.5 mg,po,qd;观察组患者在此基础上给予复方鳖甲软肝片2.0 g,po,tid。两组患者均连续治疗12个月。观察两组患者治疗前后中医证候评分,肝功能指标[包括天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、碱性磷酸酶(ALP)和谷氨酰转移酶(GGT)]、血清胆红素[包括总胆红素(TBIL)、直接胆红素(DBIL)和间接胆红素(IBIL)]、肝纤维化指标[包括层粘连蛋白(LN)、透明质酸(HA)、Ⅲ型前胶原(PⅢP)和Ⅳ型胶原蛋白(Ⅳ-C)]和肝瞬时弹性硬度(FS)水平,并记录不良反应发生情况。结果:观察组脱落2例,对照组脱落3例。治疗前,两组患者中医证候评分、肝功能指标、血清胆红素、肝纤维化指标和FS水平比较,差异均无统计学意义(P0.05)。治疗后,两组患者中医证候评分和TBIL、IBIL、LN、HA、PⅢP、Ⅳ-C、FS水平均明显降低,DBIL水平明显升高,且观察组明显优于对照组,差异均有统计学意义(P0.05);观察组患者AST、ALT水平明显降低,ALP、GGT水平明显升高,且观察组明显优于对照组,差异均有统计学意义(P0.05)。观察组患者不良反应发生率(9.09%)与对照组(10.91%)比较,差异无统计学意义(P0.05)。结论:复方鳖甲软肝片联合恩替卡韦片治疗慢性乙型肝炎瘀血阻络证型患者,可改善其肝功能指标及胆红素水平,抑制肝纤维化,且安全性较好。
[Abstract]:Objective: to observe the effect of compound Biejia Ruanggan tablets combined with entecavir tablets on liver function and bilirubin in patients with chronic hepatitis B syndrome of blood stasis and collaterals. Methods: the second people's Hospital of Neijiang City, affiliated Hospital of Southwest Medical University, 2015 was selected. 110 patients with chronic hepatitis B syndrome of blood stasis and collaterals were randomly divided into control group and observation group according to stratified group. 55 patients in each group were treated with entecavir 0.5 mg poqd, and the patients in observation group were treated with compound Biejia Ruangan tablet 2.0 g potid. The two groups were treated continuously for 12 months. The TCM syndromes scores before and after treatment were observed in both groups. Liver function indicators [including aspartate aminotransferase (AST), alanine aminotransferase (alt), alkaline phosphatase (ALP) and glutamyltransferase (GGTT)], serum bilirubin [including total bilirubin TBILL, direct bilirubin (DBIL) and indirect bilirubin (IBIL)], liver fibrosis indicators [. The levels of laminin, hyaluronic acid, type 鈪，

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