软肝化纤汤联合恩替卡韦治疗慢性乙型肝炎后肝纤维化(肝郁脾虚)随机平行对照研究  

Randomized Parallel Control Study of Ruangan Huaxian Decoction/软肝化纤汤 combined with Entecavir in the Treatment of Hepatic Fibrosis after Chronic Hepatitis B(Ganyu Pixu/肝郁脾虚)

作　　者：张团结[1] ZHANG Tuanjie(Xihua County People's Hospital,Xihua 466600,Henan,China)

机构地区：[1]西华县人民医院中医科

出　　处：《实用中医内科杂志》2019年第4期32-35,共4页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：[目的]观察软肝化纤汤联合恩替卡韦治疗慢性乙型肝炎后肝纤维化(肝郁脾虚)疗效。[方法]使用随机平行对照方法,将112例门诊患者按就诊顺序号方法随机分为两组。对照组56例恩替卡韦,0.5mg/次,1次/d,视耐受、年龄、病情等酌情调整剂量。治疗组56例软肝化纤汤(甘草炙6g,片姜黄、三七、龙葵、郁金、柴胡醋各10g,绞股蓝、赤芍、白花蛇舌草各15g,丹参、党参各20g,鳖甲30g),1剂/d,水煎400mL,早晚口服;恩替卡韦治疗同对照组。连续治疗6个月为1疗程。观测临床表现、血清白蛋白(ALB)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总胆红素(TBiL)、Ⅲ型前胶原肽(PⅢP)、Ⅳ型胶原(Ⅳ-C)、层黏连蛋白(LN)、透明质酸(HA)、不良反应。治疗1疗程(6个月),判定疗效。[结果]ALB、AST、ALT、TBiL两组均有改善(P<0.01),AST、ALT、TBiL治疗组改善优于对照组(P<0.01),ALB两组间无明显差异(P>0.05)。PⅢP、Ⅳ-C、LN、HA两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。[结论]软肝化纤汤联合恩替卡韦慢性乙型肝炎后肝纤维化(肝郁脾虚),疗效满意,无严重不良反应,值得推广。[Objective] To observe the effect of Ruangan Huaxian decoction combined with entecavir on liver fibrosis(Ganyu Pixu) after chronic hepatitis B. [Method] 112 outpatients were randomly divided into two groups by the method of random parallel control. In the control group, 56 cases of entecavir were given 0.5 mg/time, once a day. The dosage was adjusted according to tolerance, age and condition. The treatment group consisted of 56 cases of Ruangan Huaxian decoction(Zhigancao 6 g, Pianjianghuang, Sanqi, Longkui, Yujin,Cuchaihu each 10 g, Jiaogulan, Chishao, Baihuasheshecao 15 g, Danshen, Dangshen each 20 g, Beijia 30 g),1 dose a day, decocted in water 400 mL, taken orally in the morning and evening;entecavir was the same as the control group. Continuous treatment for 6 months is a course of treatment. Clinical manifestations, serum albumin(ALB), aspartate aminotransferase(AST), alanine aminotransferase(ALT), total bilirubin(TBiL), type Ⅲ procollagen peptide(P Ⅲ P), type IV collagen(IV-C), laminin(LN), hyaluronic acid(HA) and adverse reactions were observed. One course of treatment(6 months) was used to determine the curative effect. [Results]ALB, AST, ALT and TBiL were improved in both groups(P<0.01). The improvement of AST, ALT and TBiL in treatment group was better than that in control group(P<0.01). There was no significant difference between ALB and TBiL groups(P>0.05). PⅢ P, IV-C, LN and HA were improved in both groups(P<0.01). The improvement in treatment group was better than that in control group(P<0.01). [Conclusion] Ruangan Huaxian decoction combined with entecavir for chronic hepatitis B with hepatic fibrosis(liver depression and spleen deficiency) has satisfactory curative effect and no serious adverse reactions, which is worthy of promotion.

关 键 词：慢性乙型肝炎 肝纤维化 臌胀 积聚 胁痛 软肝化纤汤 恩替卡韦 血清白蛋白 天门冬氨酸氨基转移酶 丙氨酸氨基转移酶 总胆红素 Ⅲ型前胶原肽 Ⅳ型胶原 层黏连蛋白 透明质酸 中药复方 随机平行对照研究 

分 类 号：R575.2[医药卫生—消化系统] R512.62[医药卫生—内科学]