健脾疏肝汤加减联合恩替卡韦治疗乙肝肝硬化失代偿期的效果  

Effect of modified Jianpi Shugan Decoction combined with Entecavir in treatment of decompensated cirrhosis

作　　者：张宇 柯华菁 吴刚[1] ZHANG Yu;KE Hua-jing;WU Gang(Department of Hepatology,the First People′s Hospital of Jiujiang Cityin Jiangxi Province,Jiujiang332000,China;Department of Rehabilitation,the First People′s Hospital of Jiujiang City in Jiangxi Province,Jiujiang332000,China)

机构地区：[1]江西省九江市第一人民医院肝病科,江西九江332000 [2]江西省九江市第一人民医院康复科,江西九江332000

出　　处：《中国当代医药》2020年第36期67-69,73,共4页China Modern Medicine

摘　　要：目的探讨健脾疏肝汤加减联合恩替卡韦治疗乙肝肝硬化失代偿期的效果。方法选取2017年5月~2019年6月江西省九江市第一人民医院收治的160例乙肝肝硬化失代偿期患者作为研究对象,按随机数字表法分为对照组(80例)与观察组(80例)。对照组采用恩替卡韦治疗,观察组采用健脾疏肝汤加减联合恩替卡韦治疗。比较两组的总有效率、治疗前后中医证候积分及肝功能指标水平[天冬氨酸转氨酶(AST)、谷氨酸转氨酶(ALT)、总胆红素(TBil)及清蛋白(ALB)、乙肝病毒定量(HBV-DNA)]、不良反应。结果观察组的总有效率高于对照组,差异有统计学意义(P<0.05);治疗后,观察组的中医证候积分低于对照组,差异有统计学意义(P<0.05);观察组治疗后的AST、ALT、TBil、HBV-DNA水平低于对照组,ALB水平高于对照组,差异均有统计学意义(P<0.05);两组用药期间均未出现明显不良反应。结论健脾疏肝汤加减联合恩替卡韦治疗乙肝肝硬化失代偿期患者效果确切,可有效降低中医证候积分,改善肝功能指标,无明显不良反应,安全性高,值得推广应用。Objective To investigate the effect of modified Jianpi Shugan Decoction combined with Entecavir in treatment of decompensated cirrhosis.Methods A total of 160 patients with decompensated cirrhosis who were admitted to the First People′s Hospital of Jiujiang City in Jiangxi Province from May 2017 to June 2019 were selected as the research subjects.All the patients were divided into control group(80 cases)and observation group(80 cases)according to the random number table method.The control group was treated with Entecavir,while observation group was treated with modified Jianpi Shugan Decoction combined with Entecavir.The total effective rate,traditional Chinese medicine(TCM)syndrome score,liver function indexes(aspartate aminotransferase[AST],alanine transaminase[ALT],total bilirubin[TBil],albumin[ALB])before and after treatment,and the incidence of adverse reactions were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group,with statistical difference(P<0.05).The TCM syndrome score of the observation group was lower than that of the control group after treatment,with statistical difference(P<0.05).The levels of AST,ALT,TBil,ALB and HBV-DNA in the observation group were lower than those in the control group after treatment,with statistical differences(P<0.05).No obvious adverse reactions occurred during the two groups of medication.Conclusion Modified Jianpi Shugan Decoction combined with Entecavir in treatment of patients with decompensated cirrhosis is effective,it can decrease TCM syndrome score,improve indexes of liver function,and have no obvious adverse reactions,which has high safety and is worthy of promotion and application.

关 键 词：乙肝肝硬化失代偿期 健脾疏肝汤 恩替卡韦 中医证候积分 肝功能 不良反应 

分 类 号：R512.62[医药卫生—内科学]