摘要
目的 探讨中药治疗慢性乙型肝炎肝纤维化的临床疗效并调查慢性乙型肝炎患者的生存质量. 方法 将430例慢性乙型肝炎肝纤维化患者随机分为治疗组和对照组.治疗组(220例)给予六味五灵片联合恩替卡韦分散片进行治疗,对照组(210例)仅给予恩替卡韦分散片,疗程均为12个月.比较两组患者治疗前后肝功能、肝纤维化情况、HBV DNA载量及肝脾影像学变化情况；同时,在治疗前后,应用WHOQOL-BRFE量表测量患者的生存质量.统计学分析采用t检验或x2检验. 结果 治疗后,两组患者的肝功复常率有明显改善(t值分别为7.51、8.12、7.88,P＜ 0.05)；血清肝纤维化指标较治疗前有明显改善(t值分别为7.01、6.55、6.10、8.01,P＜0.05)；门静脉内径及脾静脉内径较治疗前明显缩小,且两组间比较,差异有统计学意义(t值分别为4.099、2.231,P＜ 0.05)；两组患者HBV DNA转阴率较治疗前升高,但两组间差异无统计学意义；治疗后,两组患者的生存质量与治疗前相比,均有提升,并且除环境领域外,各领域差异均有统计学意义(P＜ 0.05).结论 中药治疗慢性乙型肝炎肝纤维化具有较好的疗效；同时,积极治疗能有效提高患者的生存质量.
Objective To prospectively evaluate the efficacy of a traditional Chinese medicine (TCM)-based therapy for treating liver fibrosis in patients with chronic hepatitis B (CHB),and to investigate the patients' perception of the treatment's effects on quality of life (QoL).Methods A total of 430 patients with CHB-related liver fibrosis were randomly assigned to treatment groups for receipt of a 12-month course of the antiviral drug entecavir alone (control group) or in combination with the TCM Liuweiwuling tablets.Patients were assessed before (pre-treatment) and after therapy and the treatment-related differences in clinical manifestations,levels of liver function markers and liver fibrosis indexes,color ultrasound images,and hepatitis B virus (HBV) DNA load were compared between the two groups by statistical analysis.The generic QoL scale developed by the World Health Organization (WHOQOL-BREF) was used to score the patients' perceptions of treatment outcome.Results After treatment,the patients in both groups showed significant improvement in the majority of clinical manifestations (both P ＜ 0.05),with the exception of bloating.In addition,both groups showed significant improvements of liver function markers and in signs of liver fibrosis (both P ＜ 0.05).Both groups also showed significant reductions in the diameters of the portal and splenic (both P ＜ 0.05),as well as increases in the rate of undetectable HBV DNA (with a statistically similar outcome achieved in the two groups).Finally,both groups had higher QoL scores after treatment,with all assessed parameters except environment showing a significant improvement (all P ＜ 0.05).Conclusion When used in combination with entecavir,the TCM Liuweiwuling tablet is a safe therapy for CHB and its related liver fibrosis and may help to improve the QoL of these patients.
出处
《中华肝脏病杂志》
CAS
CSCD
北大核心
2014年第1期-,共3页
Chinese Journal of Hepatology
