益肝逍遥散联合拉米夫定治疗慢性乙型肝炎肝郁脾虚证临床观察  

Clinical Observation on Chronic Hepatitis B with Syndrome of Liver Stagnation and Spleen Deficiency Treated by Yigan Xiaoyao Powder Combined with Lamivudine

作　　者：张东军[1] 林翼金 李斌义[1] 俞建家[1] 蒋文秀[1] 

机构地区：[1]南通大学附属丹阳医院感染科,江苏丹阳212300

出　　处：《辽宁中医药大学学报》2014年第11期7-10,共4页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：江苏省镇江市社会发展科技计划指导性项目(FZ2010004)

摘　　要：目的:观察益肝逍遥散联合拉米夫定(LAM)治疗中度慢性乙型肝炎(CHB)肝郁脾虚证的疗效性和安全性。方法:106例中度慢性乙型肝炎肝郁脾虚证患者随机分为两组,治疗组给予乙肝逍遥散联合LAM治疗,对照组给复方益肝灵、黄芪精口服液及LAM治疗,每组连用3个月。分别检测两组患者治疗前后肝功能、血脂、肝纤维化指标(HA、LN、PCⅢ、IV-C)、HBV标志物(HBsAg、HBeAg、抗-HBc、HBV-DNA)、细胞因子(cytokines)IL-2、IL-4和肝脏B型超声直方图灰阶值(B-ultrasonic histogram gray scale of live),同时观察治疗前后中医证候积分的变化,并用统计学方法,分析比较两组患者治疗前后各项指标的差异。结果:经3个月治疗后,临床数据统计处理发现,慢性乙型肝炎患者的中医证候积分、肝功能、血脂、肝纤维化指标、乙肝病毒复制指标、IL-2、IL-4和肝脏B型超声直方图灰阶值,两组均得到不同程度的改善,治疗组好于对照组(P<0.01或P<0.05),差异均有统计学意义。治疗组的显效率和总有效率分别为60.37%和81.13%,显著高于对照组的24.52%和54.72%(P<0.01或P<0.05)。结论:益肝逍遥散联合LAM治疗慢性中度乙型肝炎肝郁脾虚证疗效显著,副作用少,安全度高且复发率低(3.8%)。Objective：To study the efficacy and safety of Yigan Xiaoyao Powder combined with LAM in the treatment of chronic moderate hepatitis B with syndrome of liver stagnation and spleen deficiency.Methods：106 cases with chronic moderate hepatitis B with syndrome of liver stagnation and spleen deficiency were randomly divided into two groups.The treatment group received Yigan Xiaoyao Powder combined with lamivudine（LAM）and the control group received Compound Yiganling and Huangqijingoral liquor combined with LAM each for three months.The patients＇ serum levels of liver functions（ALT,AST,TBIL,γEP,A/G,Alb）,blood lipids（TC,TG,HDL-C,LDL-C,Apo-A1,Apo-B）,liver fibrosis index（HA,LN,PCⅢ,IV-C）,HBV markers（HbsAg,HBeAg,anti-HBc,HBV-DNA）,IL-2,IL-4 and B-ultrasonic histogram gray scale of liver were measured and the marks of TCM syndrome score were recorded before and after treatment.Data was dealt with and analyzed by statistic software SPSS.And the side effects were observed.Result：After three months treatment,statistically,such targets of the patients as TCM syndrome,liver functions,blood lipids,liver fibrosis index and so on were differently improved in both groups with treatment group much better than those of control group（P0.01 or P0.05）,and the obvious effective rate of the treatment group was 60.37% and the total response rate was 81.13%,which were significantly higher than those of control group（24.52% and 54.72%）（P0.01 or P0.05）.Conclusion：Yigan Xiaoyao Powder combined with LAM has a significant curative effect,few side effect,high safety and low recurrence rate（3.8%）in treatment of chronic moderate hepatitis B with syndrome of liver stagnation and spleen deficiency.

关 键 词：慢性乙型肝炎 肝郁脾虚证 益肝逍遥散 拉米夫定 超声直方图 

分 类 号：R512.62[医药卫生—内科学]