健脾软肝颗粒治疗慢性乙型肝炎肝纤维化的临床研究  

Clinical Study on Hepatic Fibrosis of Chronic Hepatitis B Treated with Jianpi Ruangan Granule(健脾软肝颗粒)

作　　者：唐跃华 丁贤君 周国儿 汪丙柱 王双养 TANG Yuehua;DING Xianjun;ZHOU Guoer;WANG Bingzhu;WANG Shuangyang(Chinese Medicine Hospital of Zhoushan, Zhoushan, Zhejiang 316000)

机构地区：[1]舟山市中医院脾胃病科,浙江舟山316000

出　　处：《中国中医药科技》2019年第3期331-334,共4页Chinese Journal of Traditional Medical Science and Technology

基　　金：浙江省舟山科技局项目(2015C31035);浙江省舟山市卫生局课题项目(2015B01)

摘　　要：目的:观察健脾软肝散联合恩替卡韦抗乙肝肝纤维化临床疗效及安全性。方法:将60例慢性乙肝肝纤维化患者按1:1比例随机纳入观察组和对照组,观察组给予健脾软肝颗粒(中药配方颗粒剂)联合恩替卡韦,对照组给予恩替卡韦,治疗6个月,观察治疗前后症状体征、血清纤维化指标、APRI指数(AST与血小板比值)及声脉冲辐射力成像技术(ARFI)检测肝横向剪切波速度(s)等。结果:观察组患者症状、体征改善优于对照组(P<0.05);两组患者治疗后HA、LN、CV-IV、PIIIP较治疗前均有下降,观察组CV-IV治疗前后比较差异有统计学意义(P<0.05),余均无明显差异;两组治疗后APRI评分均较治疗前均有下降(P<0.05),但两者下降的幅度无明显差异(P>0.05); ARFI检测值,两组治疗后均较治疗前均有下降(P<0.05),但观察组下降幅度优于对照组(P<0.05)。治疗过程中,2例患者出血胃部不适,程度轻,自行缓解。结论:健脾软肝颗粒联合恩替卡韦能够改善慢性乙肝肝纤维化的临床症状,对肝纤维化程度有一定的减轻作用,提高患者生活质量。Objective: To observe the curative effect of hepatic fibrosis of hepatitis B treated with Jianpi Ruangan Granule and the safety. Methods: 60 cases with hepatic fibrosis of hepatitis B were divided into observation and control groups, observation group was treated with Jianpi Ruangan Granule combining with Entecavir, control group was treated with Entecavir, they were treatwd for 6 months. The Changes of clinical symptoms and signs, serum hepatic fibrosis indexes (HA, LN, CV-IV, PIIIP), APRI and transverse shear wave velocity of liver determined by ARFI. Results: The improvement of clinical symptoms and signs in observation group was more obvious than that of control group, serum hepatic fibrosis indexes (HA、LN、CV-IV、PIIIP) in the two groups were decreased, CV-IV change of the observation group was significant between before and after treatment, the other indexes changes had no significant;APRI score of the two groups was lowered after treatment, there was no significance between the two groups after treatment. The transverse shear wave velocity of liver of the two groups was decreased, that in observation group was significant lower than that in control group ( P <0.05). Conclusion: Jianpi Ruangan Granule combined with Entecavir can improve the clinical symptoms of chronic hepatitis B liver fibrosis and reduce the degree of liver fibrosis, raise life quality.

关 键 词：健脾软肝散 慢性乙型肝炎 肝纤维化 APRI指数 肝横向剪切波速度 

分 类 号：R259[医药卫生—中西医结合]