Clinical effect of Dahuang Zhechong capsules combined with entecavir in treatment of chronic hepatitis B patients with liver fibrosis

Xie YongCai; Hu GuoXin; Peng YanZhong; Zheng Jie; Li YinPing

doi:10.3969/j.issn.1001-5256.2016.08.014

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Aug. 2016

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Article Navigation > Journal of Clinical Hepatology > 2016 > 32(8): 1502-1507

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Clinical effect of Dahuang Zhechong capsules combined with entecavir in treatment of chronic hepatitis B patients with liver fibrosis

DOI: 10.3969/j.issn.1001-5256.2016.08.014

Guangzhou Medical University

Research funding:

Published Date: 2016-08-20

Abstract

Abstract

Objective To investigate the clinical effect of Dahuang Zhechong capsules combined with entecavir in the treatment of chronic hepatitis B( CHB) patients with liver fibrosis. Methods A total of 100 CHB patients with liver fibrosis who visited or were hospitalized in Shenzhen Hospital of Peking University from October 2014 to January 2016 were enrolled and randomly divided into Western medicine group and combined treatment group,with 50 patients in each group. The patients in the Western medicine group were given entecavir,and those in the combined treatment group were given Dahuang Zhechong capsules in addition to entecavir. The course of the treatment was 48 weeks.The changes in liver function,HBV DNA load,four serum parameters of liver fibrosis,liver stiffness,and aspartate aminotransferase- to-platelet ratio index( APRI) / Fibro Index were observed in both groups. The t- test was used for comparison of continuous data between groups,and the chi- square test was used for comparison of categorical data between groups. Results Both groups showed significant reductions in serum levels of aspartate aminotransferase( AST),alanine aminotransferase( ALT),and HBV DNA load after 48 weeks of treatment( all P < 0. 05). After treatment,the four serum parameters of liver fibrosis all returned to normal after treatment,and the serum levels of hyaluronic acid,type Ⅲ precollagen,and type IV collagen showed significant differences between the two groups( all P < 0. 05),and the portal vein diameter,thickness of the spleen,liver stiffness and APRI / Fibro Index also showed significant differences between the two groups( both P < 0. 05). The combined treatment group had a significantly higher overall response rate than the Western medicine group( 92. 0%vs 72. 0%,χ2= 6. 775,P = 0. 009). Conclusion Dahuang Zhechong capsules combined with entecavir have a better effect in the treatment of CHB patients with liver fibrosis compared with entecavir alone.
- hepatitis B,
- chronic,
- liver cirrhosis,
- DAHUANG ZHECHONG PILL,
- entecavir

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References

[1]XIE YC,HU GX.Current status of clinical and experimental studies on Dahuang Zhechong pills in liver disease[J].Chin J Integr Tradit West Med Dig,2015,23(12):905-910.(in Chinese)谢永财,胡国信.大黄蟅虫丸在肝病领域中的临床与实验研究现状[J].中国中西医结合消化杂志,2015,23(12):905-910.

[2] Chinese Society of Hepatology and Chinese Society of Infectious Diseases,Chinese Medical Association.The guideline of prevention and treatment for chronic hepatitis B(2010 version)[J].Chin J Infect Dis,2011,29(2):65-80.(in Chinese)中华医学会肝病学分会,中华医学会感染病学分会.慢性乙型肝炎防治指南(2010年版)[J].中华传染病杂志,2011,29(2):65-80..

[3]Liver Disease Committee,Chinese Association of Integrative Medicine.Guidelines for the diagnosis and treatment of liver fibrosis in integrative medicine practice[J].Chin J Hepatol,2006,14(11):866-870.(in Chinese)中国中西医结合学会肝病专业委员会.肝纤维化中西医结合诊疗指南[J].中华肝脏病杂志,2006,14(11):866-870.

[4]ZHANG RF,YAO YJ,YOU ZL,et al.Clinical effect observation of compound turtle shell soft liver pills combined with entecavir in treatment of liver fibrosis with chronic hepatitis B[J].J Third Milit Med Univ,2014,36(18):1961-1963.(in Chinese)张瑞凤,姚云洁,游忠岚,等.复方鳖甲软肝片联合恩替卡韦治疗慢性乙型肝炎肝纤维化的观察[J].第三军医大学学报,2014,36(18):1961-1963.

[5]LIAN J,HAN T,XIANG HL,et al.A randomized controlled trial on 240-week monotherapy with entecavir or adefovir in patients with chronic hepatitis B and cirrhosis[J].Chin J Hepatol,2015,23(10):733-737.(in Chinese)连佳,韩涛,向慧玲,等.恩替卡韦与阿德福韦酯单药治疗慢性乙型肝炎相关性肝病患者240周的随机对照研究[J].中华肝脏病杂志,2015,23(10):733-737.

[6]WIENS A,LENZI L,VENSON R,et al.Comparative efficacy of oral nucleoside or nucleotide analog monotherapy used in chronic hepatitis B:a mixed-treatment comparison meta-analysis[J].Pharmacotherapy,2013,33(2):144-151.

[7]LYU XY,LIU Q,SU JP,et al.Protective effects of Dahuangzhechongwan against rat hepatic fibrosis induced by carbon tetrachloride[J].Lishizhen Med Mater Med Res,2012,23(4):801-802.(in Chinese)吕小燕,刘强,苏娟萍,等.大黄蟅虫丸抗四氯化碳致大鼠肝纤维化的实验研究[J].时珍国医国药,2012,23(4):801-802.

[8]SHI J,TANG HL,CHEN C.Therapeutic efficacy of Dahuang Zhechong pills combined with entecavir in treatment of hepatic fibrosis due to chronic hepatitis B:a report of 20 cases[J].Hunan J Tradit Chin Med,2013,29(5):19-24.(in Chinese)石俊,汤海林,陈超.大黄蟅虫丸联合恩替卡韦治疗慢性乙型肝炎肝纤维化20例[J].湖南中医杂志,2013,29(5):19-24.

[9]GAO YZ,JIA SH,ZHAO LF,et al.Clinical efficacy of entecavir combined with xinganbao capsules in treatment of liver cirrhosis among patients with chronic hepatitis B[J].J Clin Hepatol,2014,30(4):314-316.(in Chinese)高远征,贾素华,赵连峰,等.恩替卡韦联合心肝宝胶囊治疗慢性乙型肝炎肝硬化的疗效观察[J].临床肝胆病杂志,2014,30(4):314-316.

[10]WU G,HE HY,LI Y,et al.Clinical effect of combination therapy with Fufang Biejia Ruangan tablet and entecavir in pafients with hepatitis B virus-related cirrhosis[J].Chin J Hepatol,2014,22(8):604-608.(in Chinese)吴刚,何鸿雁,李烨,等.复方鳖甲软肝片联合恩替卡韦对HBV相关肝硬化患者的临床疗效观察[J].中华肝脏病杂志,2014,22(8):604-608.

[11]JIANG YF,MA J,HE B,et al.The therapeutic effect of Anluohuaxian capsule combined with adefovir dipivoxil on patients with chronic hepatitis B and influence on hepatic histology[J].Chin J Hepatol,2012,20(5):344-347.(in Chinese)蒋永芳,马静,贺波,等.阿德福韦酯联合安络化纤丸治疗慢性乙型肝炎的疗效[J].中华肝脏病杂志,2012,20(5):344-347.

[12]HU GX,WAN ZY,SHAO JL,et al.Effects of hydroxycamptothecin on TGFβ1,α-SMA and collagen I expression in rat hepatic satellite cells[J].Chin J Hepatol,2012,20(6):453-457.(in Chinese)胡国信,万赞燕,邵佳亮,等.羟基喜树碱对大鼠肝星状细胞转化生长因子β1、α-平滑肌肌动蛋白和I型胶原表达的影响[J].中华肝脏病杂志,2012,20(6):453-457.

[13]SHAO JL,HU GX,ZHENG J,et al.Effects of hydroxycamptothecin on hepatic expression of Bax and Bcl-2 genes andα-SMA protein and hepatic fibrosis in rats[J].Acad J Second Military Med Univ,2014,35(4):399-405.(in Chinese)邵佳亮,胡国信,郑洁,等.羟基喜树碱对肝纤维化大鼠肝组织Bax、Bcl-2基因和α-SMA蛋白表达及肝纤维化的影响[J].第二军医大学学报,2014,35(4):399-405.

[14]ZHANG WS,WANG BE,WANG TL,et al.Noninvasive assessment of liver fibrosis in chronic hepatitis B using a predictive model[J].Chin J Hepatol,2006,14(3):169-173.(in Chinese)张文胜,王宝恩,王泰龄,等.慢性乙型肝炎肝纤维化无创性诊断模型的建立[J].中华肝脏病杂志,2006,14(3):169-173.

[15]QIN JH,ZHANG GD,BAI LJ,et al.The diagnostic value of Fibroscan and APRI in liver fibrosis[J/CD].Chin J Liver Dis:Electronic Edition,2015,7(3):106-108.(in Chinese)秦金环,张国栋,白留江,等.Fibroscan与谷草转氨酶-血小板指数(APRI)诊断肝纤维化的价值[J/CD].中国肝脏病杂志:电子版,2015,7(3):106-108.

[16]ZHOU JB.Application of Fibro San combined with other serologic markers on the diagnosis of liver fibrosis[J].Int J Lab Med,2013,34(4):409-411.(in Chinese)周剑波.Fibro Scan联合血清学标志物在肝纤维化诊断中的应用[J].国际检验医学杂志,2013,34(4):409-411.

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2.	易衡，何芬，王曦，冯谦，唐杰，卿小琼，孙菲菲，陈重. 超声引导下PTCD治疗晚期MOJ疗效及预后因素分析. 武汉大学学报(医学版). 2024(07): 814-819 .
3.	李鸿. 老年晚期恶性梗阻性黄疸患者实时超声弹性成像定量分析对PTCD预后的预测价值. 昆明医科大学学报. 2023(01): 122-127 .
4.	李鸿. 老年晚期恶性梗阻性黄疸患者实时超声弹性成像定量分析对PTCD预后的评估价值. 昆明医科大学学报. 2023(02): 150-155 .
5.	梁亚丽，李馨，夏俊杰. 胰腺癌梗阻性黄疸患者经皮穿刺胆管引流术后发生胰腺炎的危险因素分析. 实用癌症杂志. 2023(08): 1321-1324 .
6.	杨立新，刘茜，周晶晶，唐亚丹，傅鹏，戴峰，白淑芬. 不同方法PTCD应用于梗阻性黄疸治疗中的体会. 现代医用影像学. 2023(12): 2229-2231+2235 .
7.	华建军. 超声引导下经皮肝穿刺胆管引流术治疗对阻塞性黄疸病人胆红素水平与肝功能的影响研究. 贵州医药. 2022(02): 226-227 .
8.	黄道琼，沈小叶，刘骏，刘月娥，陈瑜. 回授法在经皮肝穿刺胆管引流术后的应用. 介入放射学杂志. 2022(03): 294-297 .
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10.	王玮，陈熙，罗丹，李启祥，尹合坤. 不同姑息性引流术对低位恶性梗阻性黄疸的近远期疗效及安全性分析. 当代医学. 2022(19): 39-42 .
11.	买买提·瓦司力，高旭升，司俊杰，徐峰. 经皮肝穿引流和支架植入在恶性梗阻性黄疸患者治疗的疗效评价. 新疆医学. 2022(07): 770-772+809 .
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13.	宋飞，向盈盈，车佳音，李红阳，徐文勇，魏凌潇，黄明. 胆道~(125)I粒子支架与金属裸支架治疗Bismuth Corlette Ⅲ型胆管癌合并梗阻性黄疸的临床对比. 昆明医科大学学报. 2022(11): 85-89 .
14.	冉庆. ERCP联合PTCD胆总管支架置入胆管引流治疗恶性梗阻性黄疸的临床价值. 医学食疗与健康. 2021(04): 86-87 .
15.	王锦程，余佩和，苏松，李波. 经内镜鼻胆管引流术与经内镜胆道支架置入术在低位恶性梗阻性黄疸术前胆道引流效果比较的Meta分析. 临床肝胆病杂志. 2021(04): 863-867 . 本站查看
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18.	张华安，周晓芳，蒋易君，张淏嘉. NRS-2002联合炎症反应标志物预测恶性梗阻性黄疸患者预后的Nomogram模型构建. 山东医药. 2021(16): 35-40 .
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20.	宋英茜，陶冶. 梗阻性黄疸经皮肝穿刺胆道引流术后胆道感染的病原菌特点及其危险因素分析. 中国实用乡村医生杂志. 2021(02): 33-36 .
21.	张志强，韩涛，崔钢，王奕，蔡恒烈，廖骞. 右肝管入路单通道横跨左右肝管引流治疗汇管区恶性梗阻性黄疸的临床研究. 中国普通外科杂志. 2021(12): 1503-1508 .
22.	傅建英. 内镜介入治疗急性梗阻性黄疸的疗效及对患者炎症因子的影响. 中外医疗. 2021(33): 57-60 .
23.	李蔚，王锡斌，崔卫东，杨青，刘会苗，杨金雨，王锡斌. 超声引导下经皮经肝胆管穿刺引流术治疗急性梗阻性化脓性胆管炎患者疗效分析. 实用肝脏病杂志. 2020(03): 447-450 .
24.	李磊. 胆道支架联合经皮肝穿刺胆管引流术对晚期恶性梗阻性黄疸的临床应用价值. 名医. 2020(08): 85-86 .
25.	张蓓，答秀维，张乐. 经皮肝穿刺胆道外引流治疗恶性梗阻性黄疸疗效及对患者细胞免疫功能、血清直接胆红素、超敏C反应蛋白水平的影响. 陕西医学杂志. 2020(10): 1249-1252 .
26.	朱超，刘会春，胡小四，庞青，陈邦邦，李传涛. 胆道双支架联合~(125)I粒子腔内照射治疗恶性肝门部胆道梗阻的疗效分析. 介入放射学杂志. 2020(11): 1100-1104 .
27.	姜磊，都晓英，孙医学，张大坤，周凯，徐建中，陈芳芳. PTBS术治疗恶性梗阻性黄疸的临床价值及预后因素分析. 蚌埠医学院学报. 2019(09): 1202-1205+1209 .
28.	江新华. 64层螺旋CT3D成像与MRCP成像技术对胆道梗阻性疾病的诊断价值. 江西医药. 2019(11): 1336-1340 .
29.	吴子鑫，吴申伟. 经皮肝穿刺胆道支架植入治疗对恶性梗阻性黄疸患者肝功能指标、炎症指标的影响. 齐齐哈尔医学院学报. 2019(24): 3098-3099 .
30.	武飞. 经皮肝穿刺胆管引流术与Roux-en-Y胆肠吻合术治疗恶性梗阻性黄疸患者的对比研究. 中国药物与临床. 2019(23): 4098-4100 .

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Clinical effect of Dahuang Zhechong capsules combined with entecavir in treatment of chronic hepatitis B patients with liver fibrosis

DOI: 10.3969/j.issn.1001-5256.2016.08.014