茵陈蒿汤联合西药治疗慢性乙型肝炎急性发作疗效观察  

Observation on Therapeutic Effect of Virgate Wormwood Decoction Combined with Western Medicine on Acute Attack of Chronic Hepatitis B

作　　者：张飞龙 吴立盘 杨增利 徐圳 吴雪龙 杨锐 ZHANG Fei-long;WU Li-pan;YANG Zeng-li;XU Zhen;WU Xue-long;YANG Rui(Guannan Country First People's Hospital,Guannan,Jiangsu,China,222500)

机构地区：[1]灌南县第一人民医院

出　　处：《河南中医》2019年第12期1816-1819,共4页Henan Traditional Chinese Medicine

摘　　要：目的:观察茵陈蒿汤联合西药对慢性乙型肝炎(chronic hepatitis B,CHB)急性发作患者肝功能、HBVDNA载量、HBVDNA转阴率的影响。方法:选择2017年6月至2019年1月在本院就诊的CHB急性发作患者90例,按照随机数字表法分为对照组和观察组各45例,对照组采用西医常规治疗。观察组在对照组治疗的基础上采用茵陈蒿汤治疗,日1剂,分2次,每次1袋温服。两组均连续治疗48周。结果:治疗前,两组患者谷丙转氨酶(glutamic-pyruvic transaminase,ALT)、TBIL水平、HBVDNA载量比较,差异无统计学意义(P>0.05),治疗12周、24周、48周后,两组ALT、TBIL水平、HBVDNA载量较治疗前均明显降低(P<0.05),且ALT、HBVDNA载量组间比较,差异有统计学意义(P<0.05)。对照组治疗12周、24周、48周ALT复常率分别为51.11%、71.11%、75.56%,观察组治疗12周、24周、48周ALT复常率分别为64.44%、88.89%、91.11%,两组同时期ALT复常率比较,差异均有统计学意义(P<0.05)。对照组治疗12周、24周、48周后HBVDNA转阴率分别为4.44%、6.67%、44.44%,观察组治疗12周、24周、48周后HBVDNA转阴率分别为6.67%、11.11%、66.67%,两组同时期HBVDNA转阴率比较,差异均有统计学意义(P<0.05)。结论:茵陈蒿汤联合西药可以较快恢复CHB急性发作患者的AST、TBIL和HBVDNA,提高AST复常率和HBVDNA转阴率,促进肝功能恢复。Objective:To observe the effect of Virgate Wormwood Decoction combined with Western medicine on liver function,HBV DNA load and HBV DNA negative rate in acute attack of chronic hepatitis B(CHB).Methods:A total of 90 patients with acute attack of CHB treated in our hospital from June 2017 to January 2019 were selected and divided into the control group and the observation group,with 45 cases in each according to the random number table method.The control group was treated with conventional western medicine,while the observation group was treated with Virgate Wormwood Decoction on the basis of the control group,one dose a day,twice,one bag of warm decoction taken each time.Both groups were treated for 48 weeks.Results:Before treatment,there were no significant differences in ALT,TBIL level and HBV DNA load between the two groups(P>0.05).After 12,24 and 48 weeks of treatment,ALT,TBIL level and HBV DNA load were significantly lower than those before the treatment(P<0.05),and there was significant difference between the two groups(P<0.05).The recovery rate of the control group was 51.11%,71.11%,75.56% at 12 weeks,24 weeks and 48 weeks respectively,and that of the observation group was 64.44%,88.89% and 91.11% at 12 weeks,24 weeks and 48 weeks respectively.The difference between the two groups in the same period was statistically significant(P<0.05).The negative rate of HBV DNA was 4.44%,6.67% and 44.44% in the control group after 12,24 and 48 weeks of treatment,and 6.67%,11.11% and 66.67% in the observation group after 12,24 and 48 weeks of treatment.There was significant difference between the two groups in the same period(P<0.05).Conclusion:Virgate Wormwood Decoction combined with Western medicine can quickly recoverAST,TBIL and HBV DNA in patients with acute attack of CHB,improve the recovery rate of AST and the negative rate of HBV DNA,and promote the recovery of liver function.

关 键 词：慢性乙型肝炎 急性发作 茵陈蒿汤 《伤寒论》 《金匮要略》 张仲景 

分 类 号：R259.126.2[医药卫生—中西医结合]