标题：仙珠化纤方联合恩替卡韦治疗慢性肝纤维化疗效观察

      作者：赖丽 1，崔翔 2，黄增刚 1    安康市中医医院制剂中心 1、肝病研究所 2，陕西 安康 725000

      卷次： 2022年33卷3期

      【摘要】 目的 观察仙珠化纤方联合恩替卡韦治疗慢性肝纤维化的临床疗效。方法 选取 2016年 1月至2019年6月于安康市中医医院治疗的90例慢性肝纤维化患者作为研究对象，采用随机数表法将其分为观察组和对照组各45例，对照组患者给予恩替卡韦治疗，观察组患者在恩替卡韦治疗基础上联合仙珠化纤方治疗，疗程均为48周。比较两组患者治疗前后的肝脏瞬时弹性值(LSM)、脾脏大小(脾静脉内径、肝门静脉内径、脾脏厚度)、血小板比率指数、肝纤维化指标层黏连蛋白(LN)、透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原 (Ⅳ-C)。结果 治疗前，两组患者的LSM值、脾静脉内径、肝门静脉内径、脾脏厚度、血小板比率指数、LN、HA、PCⅢ、Ⅳ-C水平比较差异均无统计学意义(P>0.05)；治疗后，两组患者的LSM值、脾脏大小、血小板比率指数、肝纤维化指标水平均降低或减小，且观察组患者的LSM值为(10.31±3.02) kPa，明显低于对照组的(14.33±4.52) kPa，脾静脉内径、肝门静脉内径、脾脏厚度分别为(6.60±1.21) mm、(10.35±1.21) mm、(4.12±1.31) mm，明显小于对照组的(13.34±1.43) mm、(12.59±1.54) mm、(4.68±1.23) mm，血小板比率指数为0.98±0.36，明显低于对照组的1.30±0.41，差异均有统计学意义(P<0.05)；治疗后，观察组患者的 LN、HA、PCⅢ、Ⅳ-C水平分别为(87.56±21.43) ng/mL、(158.21±26.49) ng/mL、(105.23±22.17) ng/mL、(72.35±23.78) ng/mL，明显低于对照组的 (114.25±23.34) ng/mL、(237.56±25.39) ng/mL、(127.85±21.38) ng/mL、(96.71±20.36) ng/mL，差异均有统计学意义(P<0.05)。结论 仙珠化纤方联合恩替卡韦治疗慢性肝纤维化可有效降低患者的肝脏弹性纤维化扫描值，使脾脏大小维持在合理范围内，降低血小板比率指数，改善肝纤维化程度，值得推广应用。
      【关键词】 仙珠化纤方；恩替卡韦；慢性肝纤维化；作用机制；疗效
      【中图分类号】 R575 【文献标识码】 A 【文章编号】 1003—6350（2022）03—0292—04

Effect of Xianzhu Huaxian formula combined with entecavir on chronic hepatic fibrosis.
LAI Li 1, CUI Xiang 2,HUANG Zeng-gang 1. Preparation Center 1, Institute of Liver Diseases 2, Ankang Hospital of Traditional Chinese Medicine,Ankang 725000, Shaanxi, CHINA
【Abstract】 Objective To observe the clinical efficacy of Xianzhu Huaxian forumula combined with entecavirin the treatment of chronic liver fibrosis. Methods A total of 90 patients with chronic liver fibrosis who were treated inAnkang Hospital of Traditional Chinese Medicine from January 2016 to June 2019 were selected and divided into the ob-servation group and control group according to random number table method, with 45 cases each group. The patients inthe control group were given entecavir treatment, patients in the observation group were treated with Xianzhu Huaxianformula on the basis of entecavir treatment, and the course of treatment was 48 weeks. The instantaneous liver elasticityvalue (LSM) value, spleen size (splenic vein diameter, hepatic portal vein diameter, spleen thickness), platelet ratio in-dex, liver fibrosis index laminin (LN), transparency Acidic acid (HA), type Ⅲ procollagen (PC Ⅲ), type Ⅳ collagen(Ⅳ-C) of the two groups of patients were compared before and after treatment. Results Before treatment, there was nosignificant difference in LSM value, splenic vein diameter, hepatic portal vein diameter, spleen thickness, platelet ratioindex, LN, HA, PCⅢ, and IV-C levels between the two groups of patients (all P>0.05); After treatment, the LSM value,spleen size, platelet ratio index, and liver fibrosis index levels of the two groups decreased or decreased. The LSM valueof the observation group was (10.31 ± 3.02) kPa, which was significantly lower than (14.33 ± 4.52) kPa of the controlgroup (P<0.05); the inner diameter of the splenic vein, the inner diameter of the hepatic portal vein, and the thickness ofthe spleen were (6.60±1.21) mm, (10.35±1.21) mm, and (4.12±1.31) mm, respectively, which were significantly small-er than corresponding (13.34±1.43) mm, (12.59±1.54) mm, (4.68±1.23) mm of the control group (P<0.05); platelet ra-tio index was 0.98±0.36, which was significantly lower than 1.30±0.41 of the control group (P<0.05); after treatment,the levels of LN, HA, PCⅢ, and Ⅳ-C in the observation group were (87.56±21.43) ng/mL, (158.21±26.49) ng/mL,(105.23±22.17) ng/mL, (72.35±23.78) ng/mL, respectively, which were significantly lower than corresponding (114.25±23.34) ng/mL, (237.56±25.39) ng/mL, (127.85±21.38) ng/mL, (96.71±20.36) ng/mL of the control group (all P<0.05).