论文部分内容阅读
目的:观察恩替卡韦联合疏肝健脾方治疗慢性乙型病毒性肝炎的临床疗效。方法:将112例中医辨证为肝郁脾虚证的慢性乙型肝炎患者按照随机数字表法分为2组各56例,对照组给予恩替卡韦进行治疗,观察组在对照组治疗方案的基础上予疏肝健脾方进行治疗,2组均治疗48周。观察治疗前后2组临床症状、体征改善情况,乙肝病毒e抗原(HBeAg)、乙肝病毒脱氧核糖核酸(HBV-DNA)转阴情况,并于治疗前及治疗后检测2组肝纤维指标[透明质酸(HA)、层粘连蛋白(LN)、Ⅳ型胶原(Ⅳ-C)、Ⅲ型前胶原(P-Ⅲ-P)]及肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBil)、白蛋白(Alb)]。结果:观察组总有效率80.4%,高于对照组60.7%,差异有统计学意义(P<0.05)。治疗后,2组中医证候总积分均较治疗前下降,差异均有统计学意义(P<0.05),观察组积分值低于对照组,2组间比较,差异有统计学意义(P<0.05)。中医证候总有效率观察组91.1%,高于对照组73.2%,差异有统计学意义(P<0.05)。治疗后,2组HA、LN、Ⅳ-C、P-Ⅲ-P均较治疗前降低,差异均有统计学意义(P<0.05),但观察组降低更为明显,差异均有统计学意义(P<0.05)。治疗后,2组ALT、AST、TBil、Alb均较治疗前有改善,差异均有统计学意义(P<0.05),观察组改善更为明显,差异均有统计学意义(P<0.05)。观察组HBeAg转阴率及HBV-DNA转阴率均高于对照组,差异均有统计学意义(P<0.05)。结论:恩替卡韦联合疏肝健脾方可改善慢性乙型病毒性肝炎患者的临床症状,临床疗效良好,其作用机制可能与改善患者肝功能,抑制肝纤维化有关。
Objective: To observe the clinical efficacy of entecavir and Shuganjianpi Decoction in the treatment of chronic hepatitis B virus. Methods: One hundred and twenty-two Chinese patients with chronic hepatitis B with syndrome of stagnation of liver-qi and spleen-asthenia were divided into two groups of 56 cases according to the random number table. The control group was given entecavir for treatment. The observation group was given control group Liver spleen side for treatment, two groups were treated for 48 weeks. The clinical symptoms, signs and symptoms, HBeAg and HBV-DNA negative were observed in 2 groups before and after treatment. The liver fibrosis indexes of two groups were detected before and after treatment [hyaline (HA), laminin (LN), type Ⅳ collagen (Ⅳ-C), type Ⅲ procollagen (P-Ⅲ-P) and liver function indexes (ALT, AST, , Total bilirubin (TBil), albumin (Alb)]. Results: The total effective rate in observation group was 80.4%, higher than that in control group (60.7%), the difference was statistically significant (P <0.05). After treatment, the total scores of TCM syndromes in both groups were significantly lower than those before treatment (P <0.05), and the scores in observation group were lower than those in control group. There was significant difference between the two groups (P < 0.05). The total effective rate of TCM syndrome observation group was 91.1%, which was higher than that of the control group (73.2%), the difference was statistically significant (P <0.05). After treatment, the levels of HA, LN, Ⅳ-C and P-Ⅲ-P in two groups were significantly lower than those before treatment (P <0.05), but the reduction in the observation group was more obvious with statistical significance (P <0.05). After treatment, the ALT, AST, TBil and Alb in both groups improved compared with that before treatment, the differences were statistically significant (P <0.05). The improvement in the observation group was more obvious with significant difference (P <0.05). The HBeAg negative rate and HBV-DNA negative rate in the observation group were higher than those in the control group, the difference was statistically significant (P <0.05). Conclusion: Entecavir combined with Shuganjianpi can improve the clinical symptoms of patients with chronic hepatitis B, the clinical curative effect is good, and its mechanism may be related to improving liver function and inhibiting hepatic fibrosis in patients.