目的 探討云芝胞內(nèi)糖肽膠囊聯(lián)合雙環(huán)醇片治療老年慢性乙型肝炎的臨床療效。方法 選取2020年5月—2021年5月重慶市大足區(qū)人民醫(yī)院接診治療的104例老年慢性乙型肝炎患者，根據(jù)治療藥物的不同分為對照組和治療組，每組各52例。對照組口服雙環(huán)醇片，25 mg/次，3次/d；在此基礎(chǔ)上，治療組口服云芝胞內(nèi)糖肽膠囊，1 g/次，3次/d。兩組患者均連續(xù)治療6個月。觀察兩組患者臨床療效，比較治療前后兩組患者臨床癥狀改善時間，肝功能丙氨酸氨基轉(zhuǎn)移酶（ALT）、總膽紅素（TBIL）、白蛋白（ALB）、天氨酸氨基轉(zhuǎn)移酶（AST）、APRI和FIB-4及血清微纖維相關(guān)蛋白4（MFAP4）、高爾基體蛋白73（GP73）、結(jié)締組織生長因子（CTGF）、T淋巴細胞免疫球蛋白黏蛋白分子-3（Tim-3）和Mac-2結(jié)合蛋白糖基化異構(gòu)體（M2BPGi）水平。結(jié)果 經(jīng)治療，治療組臨床有效率為98.08%，顯著高于對照組80.77%（P＜0.05）。經(jīng)治療，治療組臨床癥狀改善時間優(yōu)于對照組（P＜0.05）。經(jīng)治療，兩組ALT、TBIL、AST表達均明顯降低，而ALB明顯升高（P＜0.05），且治療組改善最明顯（P＜0.05）。經(jīng)治療，兩組APRI、FIB-4均明顯下降（P＜0.05），但治療組下降最明顯（P＜0.05）。經(jīng)治療，兩組患者血清MFAP4、GP73、CTGF、Tim-3、M2BPGi表達明顯降低（P＜0.05），且治療組下降最明顯（P＜0.05）。結(jié)論 云芝胞內(nèi)糖肽膠囊聯(lián)合雙環(huán)醇片治療老年慢性乙型肝炎效果明顯，可改善患者臨床癥狀，促進患者肝功能恢復(fù)，降低纖維化程度，改善血清細胞因子表達。

Objective To explore the clinical efficacy of Polystictus Glycopeptide Capules combined with Bicyclol Tablets in treatment of elderly chronic hepatitis B. Methods Patients (104 cases) with chronic hepatitis B in the People's Hospital of Dazu, Chongqing from May 2020 to May 2021 were randomly divided into control and treatment group, and each had 52 cases. Patients in the control group were po administered with Bicyclol Tablets, 25 mg/time, three time daily. Patients in the treatment group were po administered with Polystictus Glycopeptide Capules on the basis of the control group, 1 g/time, three times daily. Patients in two groups were treated for 6 months. After treatment, the clinical evaluation was evaluated, the improvement time of clinical symptoms, liver function indexes ALT, TBIL, AST, ALB, APRI and FIB-4, and the levels of serum MFAP4, GP73, CTGF, Tim-3 and M2BPGi in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 98.08%, which was significantly higher than that of the control group (80.77%) (P < 0.05). After treatment, the improvement time of clinical symptoms in the treatment group was better than that in the control group (P < 0.05). After treatment, the expression of ALT, TBIL and AST were significantly decreased, while ALB were significantly increased in two groups (P < 0.05), and the treatment group improved most obviously (P < 0.05). After treatment, APRI and FIB-4 were significantly decreased in two groups (P < 0.05), but the decrease was the most obvious in the treatment group (P < 0.05). After treatment, the expression of serum MFAP4, GP73, CTGF, Tim-3 and M2BPGi in two groups were significantly decreased (P < 0.05), especially in the treatment group (P <0.05). Conclusion The effect of Polystictus Glycopeptide Capules combined with Bicyclol Tablets in treatment of elderly chronic hepatitis B is obvious, which can improve the clinical symptoms, promote the recovery of liver function, reduce the degree of fibrosis and improve the expression of serum cytokines.

R975

重慶市大足區(qū)科技計劃項目(DZKJ2019ACC1030)