[1]田水林,施 琳,施卫兵△.逍遥散联合恩替卡韦治疗肝郁脾虚型慢性乙型肝炎疗效研究*[J].陕西中医,2020,(6):754-757.[doi:DOI:10.3969/j.issn.10007369.2020.06.015]
 TIAN Shuilin,SHI Lin,SHI Weibing..Study on effect of Xiaoyao powder combined with entecavir on patients with chronic hepatitis B of Ganyu Pixu type[J].,2020,(6):754-757.[doi:DOI:10.3969/j.issn.10007369.2020.06.015]
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逍遥散联合恩替卡韦治疗肝郁脾虚型慢性乙型肝炎疗效研究*
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2020年6期
页码:
754-757
栏目:
临床研究
出版日期:
2020-06-01

文章信息/Info

Title:
Study on effect of Xiaoyao powder combined with entecavir on patients with chronic hepatitis B of Ganyu Pixu type
作者:
田水林1施 琳1施卫兵2△
1.安徽省六安市中医院肝病科(六安 237006); 2.安徽中医药大学第一附属医院(合肥 230031)
Author(s):
TIAN ShuilinSHI LinSHI Weibing.
Department of Hepatology,Liu'an Traditional Chinese Medicine Hospital in Anhui Province(Liu'an 237006)
关键词:
慢性乙型肝炎 肝郁脾虚 恩替卡韦 逍遥散 HBV-DNA 肝脏硬度
Keywords:
Chronic hepatitis B Ganyu Pixu Entecavir Xiaoyao powder HBV-DNA Liver hardness
分类号:
R575.1
DOI:
DOI:10.3969/j.issn.10007369.2020.06.015
文献标志码:
A
摘要:
目的:探究逍遥散联合恩替卡韦治疗肝郁脾虚型慢性乙型肝炎(CHB)的临床疗效。方法:选取慢性乙型肝炎患者100例,用随机数字表法将患者分为观察组和对照组,每组各50例。对照组给予恩替卡韦治疗,观察组给予恩替卡韦加逍遥散,比较两组患者的中医证候、血清病毒载量、肝脏硬度及不良反应等相关指标。结果:治疗3个月后,观察组的各项中医证候评分均低于对照组(P<0.05),临床疗效总有效率为92.00%高于对照组的76.00%(P<0.05)。治疗3个月后HBV-DNA转阴率观察组仍高于对照组,FS值小于对照组(P<0.05)。治疗6个月后,观察组的HBV-DNA转阴率高于对照组(P<0.05),FS值小于对照组(P<0.05)。两组患者均未出现严重的不良反应,总不良反应发生率比较,无统计学差异(P>0.05)。结论:逍遥散联合恩替卡韦治疗,能有效改善肝郁脾虚型CHB患者的临床证候,促进HBV-DNA阴转,降低肝脏硬度,且不良反应较少。
Abstract:
Objective:To explore clinical curative effect of Xiaoyao powder combined with entecavir on chronic hepatitis B(CHB)of Ganyu Pixu type.Methods:Total of 100 CHB patients were divided into observation group and control group by random number table method,50 cases in each group.The control group were treated with entecavir,while observation group were treated with entecavir and Xiaoyao powder.TCM symptoms,serum viral load,liver stiffness and adverse reactions were compared between the two groups.Results:After 3 months of treatment,scores of all TCM syndromes in the observation group were lower than those in the control group(P<0.05),while total response rate of clinical curative effect was higher than that in the control group(92.00% vs 76.00%)(P<0.05).After 3 months of treatment,negative conversion ratio of HBV-DNA in the observation group was higher than that in the control group(P>0.05),while FS value was less than that in the control group(P<0.05).After 6 months of treatment,negative conversion ratio of HBV-DNA in the observation group was higher than that in control group(P<0.05),and the FS value was smaller than that of the control group(P<0.05).There were no serious adverse reactions in either group.There was no significant difference in total incidence of adverse reactions between the two groups(P>0.05).Conclusion: Xiaoyao powder combined with entecavir can effectively improve clinical symptoms of CHB patients of Ganyu Pixu type,promote negative conversion of HBV-DNA,reduce liver stiffness,with few adverse reactions.Its clinical curative effect is better than that of entecavir alone.

参考文献/References:

[1] Ott JJ,Stenvens GA,Groeger J,et al. Global epidemiologyof hepatitis B virus infection:new estimates of age-specificHBsAg seroprevalence and endemicity[J].Vaccine,2012,6(12):2212-2219.
[2] 郭俊霞,魏晓华.乙肝肝硬化患者合并原发性肝癌的危险因素及预后分析[J].陕西医学杂志,2019,48(7):850-852.
[3] 段淑红,苑晓冬,刘晓燕,等.持续及间断应用拉米夫定或恩替卡韦治疗慢性乙型肝炎出现病毒耐药变异概率的临床观察[J].中华肝脏病杂志,2018,26(9):646-649.
[4] 郑清兴,徐 伟,陆云飞,等.中医外治联合恩替卡韦治疗慢性乙型肝炎50例临床研究[J].江苏中医药,50(6):156-158.
[5] 中华医学会肝病学分会.慢性乙型肝炎诊断标准(2015年版)[J].中西医结合肝病杂志,2015,25(6):70-72.
[6] 中医药学会内科肝胆病学组,世界中医药联合学会肝病专业委员会,中国中西医结合学会肝病分组.慢性乙型肝炎中医诊疗专家共识[J].临床肝胆病杂志,2012,28(3):164-168.
[7] 世界中医药学会联合会肝病专业委员会标准.慢性乙型肝炎(ALT≥2×ULN)中医证候诊断标准[J].中医杂志,2015,56(1):89-90.
[8] 范 丽,张 婷.拉米夫定、阿德福韦酯、恩替卡韦治疗失代偿期乙型肝炎肝硬化临床研究[J].陕西医学杂志,2019,48(7):939-941..
[9] 田 甜,张星华,廖志峰,等.中西医结合治疗肝纤维化血清纤维标志物的Meta分析[J].中医临床研究,2016,8(1):1-5.
[10] 兰 静,曹彦丙.恩替卡韦联合霉酚酸酯治疗乙型肝炎病毒相关性肾炎疗效研究[J].陕西医学杂志,2018,47(11):1490-1492.
[11] 孙建光.加减逍遥散治疗肝郁脾虚证慢性乙型肝炎疗效观察[J].中国药物警戒,2011,8(5):16-18.
[12] 李高明,吕必华.菖郁逍遥散治疗慢性乙型肝炎伴抑郁患者负性情绪和中医证候积分的变化[J].实用肝脏病杂志,2019,22(4):498-501.
[13] Zheng H,Chen MJ,Lu S,et al.Metabolic characterization of hepatitis B virus-related liver cirrhosis using NMR-based serum metabolomics[J].Metabolomics,2017,13(10):121.
[14] 刘 杨,李明磊,贾 飞,等.逍遥散对非酒精性脂肪性肝炎肝郁脾虚证大鼠TLR-4/TRIF信号转导通路的影响[J].中国实验方剂学杂志,2018,24(17):108-113.
[15] 李劲松,曾庆贵,钟 俊.恩替卡韦对乙型肝炎肝硬化患者肝脏硬度的影响[J].西南国防医药,2018,28(1):67-68.
[16] 肖保国.扶正肝复丸联合恩替卡韦治疗肝脾湿热证慢性乙型肝炎临床研究[J].陕西中医,2018,39(7):888-890.
[17] 赵丹萍,张建军,贺 成,等.基于代谢组学技术的白芍养血柔肝作用机制研究[J].中草药,2017,48(16):3412-3418.
[18] 陈周明,李媛媛,陈青微.芍药内酯苷和芍药苷对血虚肝郁证大鼠模型的影响及作用机制研究[J].新中医,2018,50(10):22-25.

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备注/Memo

备注/Memo:
*安徽省卫生和计划生育委员会中医药科研课题(2016ZY74)
更新日期/Last Update: 2020-06-09