目的 探討虎駒乙肝膠囊聯(lián)合恩替卡韋治療慢性乙型肝炎的臨床療效。方法 選擇2011年8月-2014年8月如皋市人民醫(yī)院收治的慢性乙型肝炎患者100例,隨機(jī)分為治療組和對(duì)照組,每組各50例,對(duì)照組口服恩替卡韋分散片,0.5 mg/次,1次/d;治療組患者在對(duì)照組的基礎(chǔ)上服用虎駒乙肝膠囊,5粒/次,3次/d;兩組患者均治療3個(gè)月。治療后6個(gè)月,隨訪1次。比較兩組的臨床療效,血清乙肝標(biāo)志物相關(guān)指標(biāo)乙肝表面抗原(HBsAg)、乙肝病毒基因(HBV-DNA),血清肝功能相關(guān)指標(biāo)丙氨酸氨基轉(zhuǎn)移酶(ALT)和天冬氨酸氨基轉(zhuǎn)移酶(AST),以及血清肝纖維化相關(guān)指標(biāo)透明質(zhì)酸(HA)、層黏蛋白(LN)、Ⅲ型膠原蛋白(PCⅢ)、Ⅳ型膠原蛋白(ⅣC)。結(jié)果 治療組總有效率(90%)明顯高于對(duì)照組總有效率(84%);隨訪發(fā)現(xiàn),治療組復(fù)發(fā)率(25.0%)明顯低于對(duì)照組的復(fù)發(fā)率(34.3%),兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P < 0.05);治療后,治療組的HBsAg轉(zhuǎn)陰率、HBV-DNA轉(zhuǎn)陰率均明顯高于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P < 0.05);治療后,兩組患者的ALT和AST均顯著低于同組治療前(P < 0.05),但治療組的下降幅度均顯著高于同期對(duì)照組(P < 0.05);隨訪期,兩組的ALT和AST仍顯著低于同組治療前(P < 0.05),但與同組治療剛結(jié)束時(shí)相比均無統(tǒng)計(jì)學(xué)意義,治療組的ALT和AST仍顯著低于同期對(duì)照組(P < 0.05);治療后,兩組患者的HA、LN、PCⅢ、ⅣC均顯著低于同組治療前(P < 0.05),且治療組各指標(biāo)均顯著低于同期對(duì)照組(P < 0.05);隨訪期,兩組的HA、LN、PCⅢ、ⅣC仍顯著低于同組治療前(P < 0.05),但與同組治療剛結(jié)束時(shí)相比均無統(tǒng)計(jì)學(xué)意義,治療組的HA、LN、PCⅢ、ⅣC仍顯著低于同期對(duì)照組(P < 0.05)。結(jié)論 虎駒乙肝膠囊聯(lián)合恩替卡韋治療慢性乙型肝炎具有較好的臨床療效,具有一定的臨床推廣應(yīng)用價(jià)值。

Objetive To investigate the clinical effect of Huju Yigan Capsules combined with entecavir in treatment of chronic hepatitis B. Methods Patients (100 cases) with chronic hepatitis B in the People's Hospital of Rugao from August 2011 to August 2014 were randomly divided into control and treatment groups. Each group had 50 cases. Patients in control group were po administered with Entecavir Dispersible Tablets, 0.5 mg/time, once daily; Patients in treatment group were po administered with Huju Yigan Capsules, 5 pills/time, three times daily on the basis of control group. The patients in two groups were treated for 3 months. After treatment for 6 months, patients were followed up. The efficacy, related indicators of HBV markers in serum hepatitis B surface antigen (HbsAg) and hepatitis B gene (HBV-DNA), related indicators of liver function in serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST), and related indicators of hepatic fibrosis in serum hyaluronic acid (HA), layer fibronectin (LN), collagen Ⅲ (PCⅢ), and collagen Ⅳ (ⅣC) were compared. Results The clinical efficacy in treatment group (90%) was higher than that in control group (84%) with significant difference (P < 0.05). The follow-up data found that the recurrence rate in treatment group (25.0%) was lower than that in control group (34.3%) with significant difference (P < 0.05). After treatment, the HBsAg negating rate and HBV-DNA negating rate were higher than those in control group with significant difference (P < 0.05). After treatment, ALT and AST were lower than those in same group before treatment, and the difference was significant (P < 0.05). But the descend range in treatment group was higher than that in control group at same period with significant difference (P < 0.05). The follow-up data found that ALT and AST of two groups were lower than those in same group before treatment, but there was no significant difference. ALT and AST in treatment group were still lower than those in control group at same period with significant difference (P < 0.05). After treatment, HA, LN, PCⅢ, and ⅣC were lower than those in same group before treatment, and the difference was significant (P < 0.05). And these indicators in treatment group improved better than those in the control group at same period with significant difference (P < 0.05). The follow-up data found that HA, LN, PCⅢ, and ⅣC of two groups were lower than those in same group before treatment, but there was no significant difference. HA, LN, PCⅢ, and ⅣC in treatment group were still lower than those in control group at same period with significant difference (P < 0.05). Conclusion Huju Yigan Capsules combined with entecavir has good clinical efficacy in treatment of chronic hepatitis B, which has a certain clinical application value.