目的 探討丹參注射液聯(lián)合恩替卡韋片治療慢性乙肝肝纖維化患者的臨床療效。方法 選擇2014年10月-2015年10月西寧市第一人民醫(yī)院收治的慢性乙肝肝纖維化患者共136例作為研究對象,所有患者隨機分為對照組和治療組,每組各68例。對照組口服恩替卡韋片0.5 mg,1次/d。治療組在對照組治療的基礎(chǔ)上靜脈滴注丹參注射液,30 mL加入5%葡萄糖注射液250 mL中,1次/d。兩組均連續(xù)治療3個月。觀察兩組的臨床療效,比較兩組治療前后肝纖維化指標、血清HBV-DNA水平和血清轉(zhuǎn)化生長因子β1(TGF-β1)水平。結(jié)果 治療后,對照組、治療組總有效率分別為82.4%、94.1%,兩組總有效率比較差異具有統(tǒng)計學(xué)意義(P<0.05)。治療后,兩組患者血清透明質(zhì)酸(HA)、Ⅳ型膠原(CIV)、Ⅲ型前膠原肽(PIIINP)和層黏連蛋白(LN)水平均顯著降低,同組治療前后差異具有統(tǒng)計學(xué)意義(P<0.05);且治療組這些觀察指標降低程度明顯優(yōu)于對照組,兩組比較差異具有統(tǒng)計學(xué)意義(P<0.05)。治療后,兩組患者血清HBV-DNA、TGF-β1水平均顯著降低,同組治療前后差異具有統(tǒng)計學(xué)意義(P<0.05),且治療組血清TGF-β1水平降低程度明顯優(yōu)于對照組,兩組比較差異具有統(tǒng)計學(xué)意義(P<0.05),而治療組與對照組HBV-DNA水平比較差異無顯著性。結(jié)論 丹參注射液聯(lián)合恩替卡韋片治療慢性乙肝肝纖維化具有較好的臨床效果,能夠改善肝臟纖維化,降低血清TGF-β1水平,具有一定的臨床推廣應(yīng)用價值。

Objective To investigate clinical efficacy of Danshen Injection combined with Entecavir Tablets in treatment of chronic hepatitis B hepatic fibrosis. Methods The patients (136 cases) with chronic hepatitis B hepatic fibrosis in Xining No. 1 People's Hospital from October 2014 to October 2015 were randomly divided into control and treatment groups, and each group had 68 cases. The patients in the control group were po administered with Entecavir Tablets 0.5 mg, once daily. The patients in the treatment group were iv administered with Danshen Injection on the basis of the control group, 30 mL added into 5% Glucose Injection 250 mL, once daily. The patients in two groups were treated for 3 months. After treatment, the efficacy was evaluated, and indexes of liver fibrosis, serum levels of HBV-DNA and TGF-β1 in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 82.4% and 94.1%, respectively, and there were differences between two groups (P < 0.05). After treatment, HA, CIV, PIIINP, and LN in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, serum levels of HBV-DNA and TGF-β1 in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, serum levels of TGF-β1 in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05), but there were no difference on serum levels of HBV-DNA between two groups. Conclusions Danshen Injection combined with Entecavir Tablets has clinical curative effect in treatment of chronic hepatitis B hepatic fibrosis, and can improve liver fibrosis, and also decrease the serum levels of TGF-β1, which has a certain clinical application value.