摘要
目的:验证健脾疏肝汤辨证加减联合恩替卡韦治疗乙肝肝硬化失代偿患者的临床疗效。方法:将80例乙肝肝硬化失代偿期患者采用随机数字表法分治疗组和对照组各40例。两组均给予恩替卡韦抗病毒治疗,治疗组加用健脾疏肝汤加减,疗程均为48周。治疗12周、24周、48周检测患者的乙肝病毒定量(HBV-DNA)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、谷氨酰转肽酶(GGT)、血清白蛋白(ALB)、总胆红素(TBIL)及Child-Pugh分级评分,并统计患者的代偿期稳定率及肝癌发生率。结果:两组治疗后的HBV-DNA、血清ALT、ALB、TBIL水平及Child-Pugh分级评分水平,较治疗前均有改善(P<0.05);而两组同期的组间比较方面,在治疗12周、治疗24周的HBV-DNA、血清ALT、AST、GGT、ALB、TBIL水平及Child-Pugh分级评分水平治疗组均优于对照组(P<0.05);治疗第48周时两组HBV-DNA水平比较差异无统计学意义(P> 0.05),血清ALT、AST、GGT、ALB、TBIL水平及Child-Pugh分级评分水平比较,治疗组优于对照组(P<0.05)。两组患者在治疗后,代偿期稳定率比较,治疗组优于对照组(P<0.05),而肝癌发生率比较,治疗组高于对照组,但差异无统计学意义(P> 0.05)。结论:健脾疏肝汤辨证加减联合恩替卡韦治疗乙肝肝硬化失代偿期患者,能有效提高药物对HBV病毒复制的抑制能力,有效改善患者的生化功能,提高患者的残存肝功能,提高患者的代偿期稳定率。
Objective:To study the clinical efficacy of Jianpi Shugan decoction combined with entecavir in the treatment of decompensated cirrhosis result-ing from chronic hepatitis B. Methods:Eighty patients with decompensated cirrhosis resulting from hepatitis B were randomly divided into treatment group and control group,40 cases in each group. The control group was treated with entecavir,and the treatment group was treated with Jianpi Shugan decoction and entecavir.The treatment course lasted for 48 weeks. At the 12 th week,24 th week,and 48 th week of the treatment,quantitative assay of HBV-DNA was applied,serum alanine transaminase(ALT),aspartate aminotransferase(AST),gama glutamine transaminase(GGT),serum albumin,total bilirubin(TBIL) were examined,Child-Pugh grading scores,and the rate of compensatory phase and the incidence of liver cancer were determined. Results:On the levels of HBV-DNA,ALT,AST,GGT,ALB,TBIL and Child-Pugh grading in both groups,after treatment were better than before treatment(P< 0.05),at the 12 th and 24 th week,the treatment group was better than the control group,at the 24 th week,the treatment group was better than the control group(P< 0.05) except for the level of HBV-DNA. After treatment,on the stability rate of compensatory phase,the treatment group was better than the control group(P< 0.05),while the incidence of liver cancer was higher than that in the control group,but without statistical significance(P> 0.05). Conclusion:Jianpi Shugan decoction combined with entecavir in the treatment of decompensated cirrhosis resulting from chronic hepatitis B can effectively improve the inhibition of HBV replication,improve the patient’s biochemical function,improve the residual liver function and improve the stability rate of compensatory phase.
作者
薛建华
成扬
龚亚华
杜秀萍
陈建杰
吴香香
XUE Jianhua;CHENG Yang;GONG Yahua;DU Xiuping;CHEN Jianjie;WU Xiangxiang(Infectious Disease Hospital of Pudong New Area,Shanghai 201299;Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201203;Yueyang Integrated Traditional Chinese and Western Medcine Hospital,Shanghai 200437,China)
出处
《山东中医杂志》
2019年第12期1149-1152,1156,共5页
Shandong Journal of Traditional Chinese Medicine
基金
上海市卫计委课题(编号:20174096)
浦东新区科技发展基金项目(编号:PKJ2016-Y22)
浦东新区卫生系统优秀青年医学人才培养计划项目(编号:PWRq2016-1)
浦东新区卫生系统优秀领先人才培养计划项目(编号:PWRl2016-1)
浦东新区卫生系统重点学科建设资助项目(编号:PWZxk2017-30)
上海市综合医院中西医结合专项(编号:ZHYY-ZXYJHZX-201620)
浦东新区临床中医特色学科(编号:PDZY-2018-0607)
关键词
健脾疏肝汤
乙肝肝硬化
失代偿
恩替卡韦
乙肝病毒定量
Jianpi Shugan decoction
hepatitis B liver cirrhosis
decompensation
entecavir
quantitative assay of HBV-DNA
作者简介
薛建华(1981-),男,医学硕士,副主任医师,主要从事中西医结合肝病的临床研究。邮箱:46061278@qq.com。通信作者:吴香香(1983-),女,江苏南通人,医学硕士,主治医师,主要研究方向:中西医结合内科临床疾病的研究。邮箱:hk5771@126.com。
