[关键词]
[摘要]
目的 探讨肝达康胶囊联合恩替卡韦治疗慢性乙型肝炎的临床疗效。方法 选取2017年6月—2019年1月于新乡医学院第一附属医院感染科就诊的150例慢性乙型肝炎患者作为研究对象,所有患者随机将分为对照组(n=75)和观察组(n=75)。对照组口服马来酸恩替卡韦片,1片/次,1次/d;观察组在对照组治疗的基础上口服肝达康胶囊,8粒/次,3次/d。两组均治疗48周。观察两组患者的临床疗效,同时比较两组的肝功能水平、乙肝病毒的脱氧核糖核酸(HBV DNA)和乙型肝炎E抗原(HBeAg)转阴率、白细胞介素-17(IL-17)和白细胞介素-23(IL-23)水平。结果 治疗后,观察组总有效率为97.33%,显著高于对照组的84.00%,差异具有统计学意义(P<0.05)。治疗后,两组患者血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)和总胆红素(TBIL)水平均显著降低(P<0.05),观察组治疗后患者血清ALT、AST和TBIL水平显著低于对照组(P<0.05)。治疗24和48周后,观察组HBV DNA转阴率显著高于同期对照组,差异均具有统计学意义(P<0.05);治疗48周后,观察组HBeAg血清学转换率显著高于同期对照组,差异均具有统计学意义(P<0.05)。治疗后,两组患者血清IL-17和IL-23水平均显著降低(P<0.001),且观察组患者治疗后血清IL-17和IL-23水平显著低于对照组(P<0.01)。结论 肝达康胶囊联合恩替卡韦治疗慢性乙型肝炎疗效确切,且安全性较高,值得在临床进一步推广使用。
[Key word]
[Abstract]
Objective To explore the clinical effect of Gandakang Capsules combined with entecavir in treatment of chronic hepatitis B. Methods A total of 150 patients with chronic hepatitis B who visited the department of infectious diseases, the First Affiliated Hospital of Xinxiang Medical University from June 2017 to January 2019 were selected as the study subjects, and all the patients were randomly divided into the control group (n=75) and the observation group (n=75). Patients in the control group were po administered with Entecavir Maleate Tablets, 1 tablet/time, once daily. Patients in the observation group were po administered with Gandakang Capsules on the basis of control group, 8 grains/time, three times daily. Both groups were treated for 48 weeks. After treatment, the clinical efficacy in two groups was observed, and the liver function, HBV-DNA and HBeAg negative conversion rate, IL-17 and IL-23 levels were compared simultaneously. Results After treatment, the total effective rate of the observation group was 97.33%, which was significantly higher than 84.00% of the control group, with statistically significant difference (P<0.05). After treatment, the levels of serum ALT, AST and TBIL in two groups were significantly decreased (P<0.05), while the levels of serum ALT, AST and TBIL in the observation group were significantly lower than those in the control group (P<0.05). After 24 and 48 weeks of treatment, the HBV-DNA negative conversion rate in the observation group was significantly higher than that in the control group during the same period, and the difference was statistically significant (P<0.05). After 48 weeks of treatment, the HBeAg serological conversion rate in the observation group was significantly higher than that in the control group during the same period, with statistically significant differences (P<0.05). After treatment, the levels of serum IL-17 and IL-23 in two groups were significantly decreased (P<0.001), and the levels of serum IL-17 and IL-23 in the observation group were significantly lower than those in the control group (P<0.01). Conclusion Gandakang Capsules combined with entecavir is effective and safe in treatment of chronic hepatitis B, which is worthy of further promotion and use in clinic.
[中图分类号]
R975
[基金项目]
河南省科技发展计划项目(182102311234)