柴芍疏肝健脾汤联合恩替卡韦分散片治疗慢性乙型病毒性肝炎临床疗效观察及对患者肝功能指标的影响  

Clinical observation of Chaishao-shugan-jianpi decoction combined with entecavir dispersible tablets on chronic viral hepatitis B and its effects on liver function index

作　　者：杨卓杰[1] 蒋刚 WU Fei 

机构地区：[1]河北省保定市传染病医院肝病科,河北保定071030 [2]河北省长天药业有限公司药物研究所,河北保定071000

出　　处：《河北中医》2016年第11期1672-1675,共4页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的观察柴芍疏肝健脾汤联合恩替卡韦分散片治疗慢性乙型病毒性肝炎(以下简称慢性乙肝)的临床疗效及对患者肝功能指标的影响。方法将60例慢性乙肝患者随机分为3组。西药组20例,予恩替卡韦分散片治疗;中药组20例,予柴芍疏肝健脾汤治疗;联合组20例,予柴芍疏肝健脾汤联合恩替卡韦分散片治疗。3组均治疗6个月后观察疗效及乙型肝炎病毒脱氧核糖核酸(HBV-DNA)转阴率,并比较3组治疗前后肝功能指标谷氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBi L)及白蛋白(Alb)水平变化。结果联合组总有效率95.0%,西药组总有效率70.0%,中药组总有效率80.0%,联合组疗效优于西药组及中药组(P<0.05),西药组与中药组疗效相当(P>0.05);3组治疗后肝功能指标ALT、AST、TBi L及Alb水平与本组治疗前比较差异均有统计学意义(P<0.05),ALT、AST、TBi L水平下降,Alb水平升高,且联合组治疗后ALT及AST水平改善明显优于西药组及中药组(P<0.05),西药组与中药组治疗后肝功能指标ALT、AST、TBi L及Alb水平相当(P>0.05);联合组治疗后HBV-DNA阴转率90.0%,西药组转阴率65.0%,中药组转阴率15.0%,联合组治疗后HBV-DNA阴转率高于西药组及中药组(P<0.05),西药组治疗后HBV-DNA阴转率高于中药组(P<0.05)。结论柴芍疏肝健脾汤联合恩替卡韦分散片治疗慢性乙型病毒性肝炎可明显提高临床疗效,改善肝功能,减低ALT、AST及TBi L水平,升高Alb水平,降低HBV毒量,促进HBV-DNA转阴。Objective To observe the clinical effects of Chaishao - shugan - jianpi decoction combined with entecavir dispersible tablets on the treatment of chronic viral hepatitis B and its effects on liver function index. Meth-ods 60 patients with chronic viral hepatitis B were randomly divided into three groups. 20 cases in western medi-cine group were treated by entecavir dispersible tablets. 20 cases in Chinese medicine group were treated by Chaishao -shugan - jianpi decoction. 20 cases in combination group were treated by Chaishao - shugan - jianpi decoction combined with entecavir dispersible tablets, continuously treatment for six months. The curative effects and HBV - DNA negative conversion ratio after treatment were observed in three groups. The alanine transaminase （ALT）, as-partate aminotransferase （AST） , total bilirubin （TBiL） and albumin （ ALB） before and after treatment were com-pared in three groups. Results The total effective rate in combination, western medicine and Chinese medicine group was 95. 0% , 70. 0% and 80.0% , respectively. The curative effect in combination group was superior to west-ern medicine and Chinese medicine groups （P 〈0. 05） , and the western medicine and Chinese medicine groups had same efficacy （ P 〉 0. 05 ）. There were statistical differences on ALT, AST, TBiL and ALB after treatment among three groups （P 〈0. 05） , the levels of ALT, AST and TBiL were decreased and the ALB was increased. The improvements of ALT and AST after treatment in combination group were obvious superior to western medicine and Chinese medicine groups （ P 〈 0. 05 ） . There were equivalent levels of ALT, AST, TBiL and ALB in western medicine and Chi-nese medicine groups （P 〉 0. 05 ） . The HBV - DNA negative conversion ratio after treatment in combination, western medicine and Chinese medicine group was 90. 0% , 65. 0% and 15. 0% , respectively. The HBV - DNA negative conversion ratio in combination group wer

关 键 词：肝炎 乙型 慢性 中西医结合疗法 

分 类 号：R289.61[医药卫生—方剂学] R512.62[医药卫生—中药学]