安络化纤丸联合恩替卡韦治疗显著提高慢性乙型肝炎病毒感染患者肝纤维化的改善率
[Combined anluohuaxianwan and entecavir treatment significantly improve the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection].
作者信息
Miao L, Yang W N, Dong X Q, Zhang Z Q, Xie S B, Zhang D Z, Zhang X Q, Cheng J, Zhang G, Zhao W F, Xie Q, Liu Y X, Ma A L, Li J, Shang J, Bai L, Cao L H, Zou Z Q, Li J B, Lyu F D, Liu H, Wang Z J, Zhang M X, Chen L M, Liang W F, Gao H, Zhuang H, Zhao H, Wang G Q
机构信息
Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, Beijing 100034, China; Department of Hepatology, the Third Hospital of Qinhuangdao, Qinhuangdao 066000, China.
Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, Beijing 100034, China.
出版信息
Zhonghua Gan Zang Bing Za Zhi. 2019 Jul 20;27(7):521-526. doi: 10.3760/cma.j.issn.1007-3418.2019.07.009.
To explore the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection who received entecavir alone or in combination with anluohuaxianwan for 78 weeks. Patients with chronic HBV infection were randomly treated with entecavir alone or in combination with anluohuaxian for 78 weeks. Ishak fibrosis score was used for blind interpretation of liver biopsy specimens. The improvement in liver fibrosis condition before and after the treatment was compared. Student's t test and non-parametric test (Mann-Whitney U-Test and Kruskal-Wallis test) were used to analyze the measurement data. The categorical variables were analyzed by Chi-square test method and Spearman's rank correlation coefficient was used to test bivariate associations. Liver fibrosis improvement rate after 78 weeks of treatment was 36.53% (80/219) and the progression rate was 23.29% (51/219). The improvement of liver fibrosis was associated to the degree of baseline fibrosis and treatment methods ( < 0.05). The improvement rate of hepatic fibrosis in patients treated with anluohuaxianwan combined with entecavir at baseline < 3 (54.74%, 52/95) was significantly higher than that in patients treated only with entecavir (33.33%, 16/48), = 0.016 and the progression rate of hepatic fibrosis (13.68%, 13/95) was lower than that in patients treated alone (18.75%, 9/48), = 0.466. In patients with baseline < 3, the proportion of patients with improved and stable liver fibrosis in the combined treatment group (68.1%, 32/47) was higher than that in the treatment group alone (51.7%, 15/29). Combined anluohuaxianwan and entecavir treatment can significantly improve the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection. Furthermore, it has the tendency to improve the stability rate and reduce the rate of progression of liver fibrosis.
探讨单独使用恩替卡韦或联合安络化纤丸治疗78周的慢性乙型肝炎病毒感染患者肝纤维化的改善率。慢性HBV感染患者被随机分为单独使用恩替卡韦治疗或联合安络化纤治疗78周。采用Ishak纤维化评分对肝活检标本进行盲法解读。比较治疗前后肝纤维化状况的改善情况。采用学生t检验和非参数检验（曼-惠特尼U检验和克鲁斯卡尔-沃利斯检验）分析计量资料。分类变量采用卡方检验方法分析，Spearman等级相关系数用于检验双变量关联。治疗78周后肝纤维化改善率为36.53%（80/219），进展率为23.29%（51/219）。肝纤维化的改善与基线纤维化程度和治疗方法有关（P<0.05）。基线纤维化程度<3的患者，联合安络化纤丸和恩替卡韦治疗的肝纤维化改善率（54.74%，52/95）显著高于仅用恩替卡韦治疗的患者（33.33%，16/48），P = 0.016；肝纤维化进展率（13.68%，13/95）低于单独治疗的患者（18.75%，9/48），P = 0.466。在基线纤维化程度<3的患者中，联合治疗组肝纤维化改善和稳定的患者比例（68.1%，32/47）高于单独治疗组（51.7%，15/29）。联合安络化纤丸和恩替卡韦治疗可显著提高慢性乙型肝炎病毒感染患者肝纤维化的改善率。此外，它有提高稳定率和降低肝纤维化进展率的趋势。
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