益气解毒法联合恩替卡韦治疗HBeAg阳性慢性乙型肝炎气虚毒蕴证患者临床研究  

Clinical study on Qi deficiency and toxin retention in entecavir treatment of HBeAg positive chronic hepatitis B patients by the Method of Yiqi Jiedu

作　　者：肖明中[1,2] 邵冬珊 刘璐[3] 孟艳平 方俊 蒋满红 厉晶萍[1,2] 

机构地区：[1]湖北省中医院肝病科,湖北武汉430074 [2]湖北省中医药研究院肝病研究所 [3]湖北省黄石市中医院 [4]武汉市672医院 [5]武汉市中医院

出　　处：《中西医结合肝病杂志》2017年第5期276-278,共3页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：国家中医临床研究基地业务建设科研专项课题(No.JDZX2012055)

摘　　要：目的:本研究旨在观察益气解毒法对恩替卡韦(ETV)治疗后的HBeAg阳性慢性乙型肝炎(CHB)气虚毒殖证患者的作用,为提高核苷类似物抗病毒治疗e抗原血清转换效果提供新的思路和方法。方法:将符合纳入标准的60例患者依照就诊先后时间和随机数字表分为治疗组(30例)、对照组(30例)。对照组ETV0.5mg/次,1次/d,治疗组患者在对照组基础上加用益气解毒法中成药牛黄参胶囊,3次/d,2粒/次,疗程24周。对观察患者治疗前、中、后中医证侯进行量化积分和观察e抗原血清学转换率。结果:治疗12周后,治疗组患者神疲乏力、少气懒言、胁肋隐痛、食欲不振等症状积分较治疗前明显下降(P<0.05),而对照组患者相关症状改善不明显(P>0.05);治疗24周后治疗组患者神疲乏力、少气懒言、胁肋隐痛、食欲不振等症状积分明显低于对照组(P<0.05)。治疗24周后治疗组中医证侯总积分为(12.84±1.08),对照组为(24.62±1.25),治疗组明显低于对照组(P<0.05)。24周后治疗组发生e抗原血清学转换的患者4例,发生率为13.3%,对照组1例,发生率为3.3%。24周时治疗组患者的HBsAg定量中位水平从治疗前的6700U/mL(四分位数间距3433 U/mL)下降到5577.5U/mL(四分位数间距2844 U/mL),差异有统计学意义(P=0.006)。HBeAg定量中位水平从治疗前的11.76U/mL(四分位数间距197.3U/mL)下降到7.25U/mL(四分位数间距132.48 U/mL),差异无统计学意义(P=0.336)。结论:益气解毒法能明显改善ETV治疗后的HBeAg阳性CHB气虚毒蕴证患者的中医临床症状和体征,能够提高CHB患者e抗原血清转换率。Objective： To investigate the correlation on Qi deficiency and toxin retention in entecavir treatment of HBeAg positive chronic hepatitis B patients by the Method of Yiqi Jiedu. Methods： Total 60 patients who met the inclusion criteria were divided into treatment group （30 cases） and control group （30 cases） according to the visiting time and random number table. The control group according to the original treatment regimen unchanged （ ETV 0.5mg oral, 1 times / day）, the treatment group on the basis of the control group, plus Qi detoxification herbs （Niu Huangcan capsule, 3 times a day, 2 pills each time）, the course of treatment for 24 weeks. The TCM Syndromes of two groups were quantified and observed a;nd the seroconversion rate of e antigen was observed before, during and after treatment. Results： After 12 weeks of treatment, the symptom scores in the treatment group were lower than before treatment （P 〈 0.05）, while the control group has no obvious improvement （P 〉 0.05） ; after 24 weeks of treatment, symptom score of treatment group was significantly lower than the control group （P 〈 0.05） ; the total score of TCM syndrome in treatment group （ 12.84 ± 1.08） was lower than that of the control group（24.62 ± 1.25 ） （P 〈 0.05）. 4 patients with e antigen seroconversion occurred in the treatment group, with a rate of 13.3% and 1 cases in the control group, with a rate of 3.3% after 24 weeks treatment; HBsAg quantitative treatment in patients with a median level from 6700U/mL before treatment （ four percentile interval 3433 U/mL） down to 5577.5U/mL （ the four percentile interval 2844 U/mL）, the difference was statistically significant （Z = 2. 728, P = 0. 006）. The median level of HBeAg quantification decreased from pretreatment 11.76U/mL （ four quantile interval 197.3U/mL） to 7.25U/mL （four quantile interval 132.48 U/mL）, with no statistically significant difference （ Z = 0.961,P = 0.336）. Conclusion： Yiqi Jiedu Decoction could obvio

关 键 词：益气解毒法 HBEAG阳性慢性乙型肝炎 气虚毒蕴证 临床研究 

分 类 号：R512.62[医药卫生—内科学]