黄连温胆汤联合恩替卡韦对老年肝胆湿热证慢性乙型肝炎患者的影响OA

Objective:To explore the effect of Huanglian Wendan Decoction combined with Entecavir on elderly patients with chronic hepatitis B of liver-gallbladder damp-heat syndrome.Method:Ninety-eight elderly patients with chronic hepatitis B of liver-gallbladder damp-heat syndrome who treated in Putian Hanjiang Hospital from September 2020 to September 2022 were selected as the study objects.They were divided into combined treatment group and Entecavir group according to the random number table method,49 cases in each group.Entecavir group was given Entecavir,and combined treatment group was given Huanglian Wendan Decoction combined with Entecavir.The clinical efficacy,traditional Chinese medicine syndrome score,liver function,HBV-DNA quantitative,liver fibrosis index,interleukin-22(IL-22),heat shock protein 70(HSP70),oxidative stress index before and after treatment and adverse reactions of the two groups were compared.Result:The total effective rate of combined treatment group was higher than that of Entecavir group,and the difference was statistically significant(P<0.05).After treatment,the yellow staining of body and eyes,intercostal rib pain and yellow and red urine scores in two groups were decreased,and the yellow staining of body and eyes,intercostal rib pain and yellow and red urine scores in combined treatment group were lower than those in Entecavir group,the differences were statistically significant(P<0.05).After treatment,the levels of aspartate aminotransferase(AST),alanine aminotransferase(ALT)and total bilirubin(TBIL)in two groups were decreased,and the levels of AST,ALT and TBIL in combined treatment group were lower than those in Entecavir group,the differences were statistically significant(P<0.05).After treatment,the levels of HBV-DNA quantification and type Ⅲ procollagen(PCⅢ),laminin(LN)and hyaluronic acid(HA)in two groups were decreased,and the levels of HBV-DNA quantification and PCⅢ,LN and HA in combined treatment group were lower than those in Entecavir group,the differences were statistically significant(P<0.05).After treatment,the levels of IL-22,HSP70 and malondialdehyde(MDA)in two groups were decreased,while the levels of superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)in two groups were increased,the levels of IL-22,HSP70 and MDA in combined treatment group were lower than those in Entecavir group,and the levels of SOD and GSH-Px were higher than those in Entecavir group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion:Huanglian Wendan Decoction combined with Entecavir can significantly improve clinical efficacy and liver function,effectively prevent and treat liver fibrosis,and is safe and effective.