Clinical effect of Alprostadil combined with Compound Biejia Ruangan Tablets and Entecavir in the treatment of HBeAg positive patients with decompensated liver cirrhosis
PANG Wenyan1 YANG Hongwei2 QI Ning3 ZHANG Guoshun4
1.Department of Integrated Traditional Chinese and Western Medicine, Tangshan Central Hospital, Hebei Province, Tangshan 063000, China;
2.Department of Nephrology, Tangshan People’s Hospital, Hebei Province, Tangshan 063000, China;
3.Department of Integrated Traditional Chinese and Western Medicine, North China University of Science and Technology Affiliated Hospital, Hebei Province, Tangshan 063000, China;
4.Department of Gastroenterology, North China University of Science and Technology Affiliated Hospital, Hebei Province, Tangshan 063000, China
Abstract:Objective To explore clinical effect of Alprostadil combined with Compound Biejia Ruangan Tablets and Entecavir in the treatment of hepatitis B e antigen (HBeAg) positive patients with decompensated liver cirrhosis. Methods One hundred and eight patients with HBeAg positive hepatitis B decompensated cirrhosis hospitalized in Tangshan Central Hospital from June 2018 to June 2019 were selected and divided into control group and case group according to the random number table method, with 54 cases in each group. Control group was given Compound Biejia Ruangan Tablets and Entecavir, and case group was given Alprostadil treatment based on control group. The course of treatment was four weeks. The liver and kidney function, serum inflammatory factors, virological indexes and clinical efficacy between two groups were observed before and after treatment. Results After treatment, the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) in two groups were lower than those before treatment, and the level of albumin (ALB) was higher than that before treatment, and the levels of ALT, AST and ALP in case group were lower than those in control group, and ALB level was higher than that in control group (P < 0.05). After treatment, the levels of laminin, hyaluronic acid, type Ⅲ procollagen and type Ⅳ collagen in two groups were lower than those before treatment, and those in case group were lower than those in control group (P < 0.05). After treatment, the portal vein diameter (Dpv) and splenic vein diameter (Dsv) of two groups were shorter than those before treatment, and the portal vein blood flow velocity (Vpv), portal vein blood flow (Qpv), splenic vein blood flow velocity (Vsv), and splenic vein blood flow (Qsv) were faster than those before treatment, and Dpv and Dsv of case group were shorter than those of control group, and Vpv, Qpv, Vsv and Qsv of case group were faster than those of control group (P < 0.05). After treatment, blood urea nitrogen (BUN), creatinine (Cr) and resistance index of two groups were lower than those before treatment, and renal blood flow (RBF) was faster than that before treatment, and BUN, Cr and resistance index of case group were lower than those of control group, and RBF of case group was faster than that of control group (P < 0.05). After treatment, the serum levels of interleukin-6, interleukin-8, tumor necrosis factor-α and C-reactive protein in two groups were lower than those before treatment, and those in case group were lower than those in control group (P < 0.05). After treatment, the levels of fibrinogen like protein 2 (FGL2), toll like receptor 4 (TLR-4), transforming growth factor beta 1 (TGF-β1) and aspartate aminotransferase platelet ratio index (APRI) in two groups were lower than those before treatment, and those in case group were lower than those in control group (P < 0.05). After treatment, the negative rate of HBV DNA, HBsAg and HBeAg in case group were higher than those in control group (P < 0.05). After treatment, total effective rate of case group was higher than that of control group (P < 0.05). Conclusion Alprostadil combined with Compound Biejia Ruangan Tablets and Entecavir can improve liver and kidney function, hepatic fibrosis and portal hemodynamics in patients with HBeAg positive decompensated liver cirrhosis, reduce HBV DNA load and inflammation, reduce FGL2, TLR-4, TGF-β1 and APRI levels, improve the body’s immune status.
庞文艳1 杨宏伟2 齐宁3 张国顺4. 前列地尔联合复方鳖甲软肝片和恩替卡韦治疗HBeAg阳性的乙肝失代偿期肝硬化患者的临床效果[J]. 中国医药导报, 2020, 17(36): 130-134.
PANG Wenyan1 YANG Hongwei2 QI Ning3 ZHANG Guoshun4. Clinical effect of Alprostadil combined with Compound Biejia Ruangan Tablets and Entecavir in the treatment of HBeAg positive patients with decompensated liver cirrhosis. 中国医药导报, 2020, 17(36): 130-134.