摘要
目的观察乙肝抗纤汤联合恩替卡韦治疗乙肝肝硬化的疗效及其对炎性因子的影响。方法选择2012年1~12月就诊的乙肝后肝硬化代偿期患者94例,随机将患者分为观察组和对照组,每组47例,对照组予以恩替卡韦治疗,而观察组在对照组基础上予以乙肝抗纤汤。观察2组疗效,2组治疗前后门静脉内径,脾脏厚度,Stiffness值,乙肝病毒脱氧核糖核酸(HBV-DNA),血小板源性生长因子-BB(PDGF-BB),基质金属蛋白酶1(MMP1),基质金属蛋白酶组织抑制剂1(TIMP1),TIMP1/MMP1,白介素(IL)-6,IL-8,干扰素(INF)-γ和IL-10水平变化。结果观察组总有效率为87.23%,明显高于对照组的68.09%,2组比较差异有统计学意义(χ2=3.924,P<0.05)。2组治疗前门静脉内径、脾脏厚度、Stiffness值、HBV-DNA、PDGF-BB、MMP1、TIMP1、TIMP1/MMP1、IL-6、IL-8、INF-γ和IL-10水平差异无统计学意义(P>0.05),治疗后2组门静脉内径、脾脏厚度、Stiffness值、HBV-DNA、PDGF-BB、TIMP1、TIMP1/MMP1、IL-6和IL-8均较治疗前明显降低(P<0.01),MMP1、INF-γ和IL-10水平较治疗前明显升高(P<0.01),观察组门静脉内径、脾脏厚度、Stiffness值、PDGF-BB、MMP1、TIMP1、TIMP1/MMP1、IL-6、IL-8、INF-γ和IL-10降低或者升高更为明显(P<0.01),而HBV-DNA水平差异无统计学意义(P>0.05)。结论乙肝抗纤汤联合恩替卡韦治疗乙肝肝硬化的疗效显著,可能与乙肝抗纤汤具有改善肝细胞损伤,缓解肝纤维化,纠正机体炎性因子紊乱有关。
Objective To observe the therapeutic effects of hepatitis B anti-fibrosis decoction combined with entecavir on liver cirrhosis due to hepatitis B and their influence on inflammatory factors. Methods Ninety - four patients with liver cirrhosis due to hepatitis B at compensation period who were treated in our hospital from January 2012 to December 2015 were randomly divided into observation group and control group,with 47 patients in each group. The patients in control group were treated by entecavir, however, the patients in observation group,on the basis of control group,were treated by hepatitis B anti -fibrosis decoction. The therapeutic effects, the changes of portal vein diameter, thickness of spleen, Stiffness value, hepatitis B virus DNA （HBV-DNA） , platelet-derived growth factor-BB （PDGF-BB） , matrix metalloproteinase 1 （ MMP1 ）, tissue inhibitor of matrix metalloproteinase 1 （TIMP 1） , TIMP1/MMP1 , interleukin （IL）-6 , IL-8, interferon （INF）and IL-10 before and after treatment were observed and compared between two groups. Results The total effective rate was 87. 23% in observation group, which was significantly higher than that （68.09% ） in control group = 3. 924 , P〈0.05 ） . Before treatment there were no significant differences in the portal vein diameter, spleen thickness, Stiffness value, the levels of HBV-DNA, PDGF-BB, MMP1 , TIMP1, TIMP1/MMP1 , IL-6 , IL-8, INF-7 and IL-10 between two groups （ P〉0.05 ） , however,after treatment,the portal vein diameter, thickness of spleen, Stiffness value, the levels of HBV-DNA, PDGF-BB, TIMP1 , TIMP1/MMP1, IL-6 and IL-8 were significantly decreased in both groups, as compared with those before treatment （P〈0. 01） ,but the levels of MMP1, INF-γ and IL-10 were significantly increased （ P 〈0.01） . Moreover the decreasing or increasing levels of portal vein diameter, spleen thickness, Stiffness value, PDGF-BB, MMP1, TIMP1, TIMP1/MMP1, IL-6 , IL-8, INF-γ and IL-10 in observation group were more significant than those in control group （ P 〈0.01 ） , however, there were no significant differences in the levels of HBV-DNA between two groups （ P 〉0.05 ） . Conclusion Therapeutic effects of hepatitis B anti - fibrosis decoction combined with entecavir on liver cirrhosis due to hepatitis B are quite significant, which may be correlated to the effects of hepatitis B anti - fibrosis decoction in improving liver cell damage, alleviating liver fibrosis and correcting body＇s inflammatory cytokine disorder.
出处
《河北医药》
CAS
2017年第8期1151-1154,共4页
Hebei Medical Journal
关键词
乙型肝炎
肝硬化
肝纤维化
乙肝抗纤汤
恩替卡韦
hepatitis B
cirrhosis
liver fibrosis
hepatitis B Kangxian decoction
entecavir
