机构地区:[1]上海市浦东新区传染病医院中医科,上海201299 [2]上海中医药大学附属曙光医院肝病科,上海201203
出 处:《河北中医》2021年第2期306-311,共6页Hebei Journal of Traditional Chinese Medicine
基 金:上海市卫生和计划生育委员会中医药科研课题(编号:2018LP011);上海市浦东新区卫生和计划生育委员会临床中医特色学科建设项目(编号:PDZY-2018-0607);上海市浦东新区卫生和计划生育委员会学科建设项目(编号:PWZxk2017-30);上海市浦东新区科学技术委员会科技发展项目(编号:PKJ2016-Y22);上海市浦东新区卫生系统领先人才培养(编号:PWRl2016-01);上海市卫生健康委员会、上海市中医药管理局传染病中医药防治能力建设项目(编号:ZYYB-NLPY-04)。
摘 要:目的观察耳穴磁疗联合中药泡足治疗慢性乙型病毒性肝炎(CHB)的中医证候疗效及对患者肝功能、生活质量的影响。方法将144例CHB患者随机分为4组,恩替卡韦片组36例予恩替卡韦片治疗,耳穴磁疗+恩替卡韦片组36例予耳穴磁疗+恩替卡韦片治疗,中药泡足+恩替卡韦片组36例予中药泡足+恩替卡韦片治疗,耳穴磁疗+中药泡足+恩替卡韦片组36例予耳穴磁疗+中药泡足+恩替卡韦片治疗。4组均治疗24周。比较4组中医证候疗效;比较4组治疗前后中医证候评分变化,肝功能丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)水平变化,慢性肝脏疾病量表(CLDQ)评分变化。结果耳穴磁疗+中药泡足+恩替卡韦片组总有效率(97.22%,35/36)高于恩替卡韦片组(55.56%,20/36)、耳穴磁疗+恩替卡韦片组(77.78%,28/36)、中药泡足+恩替卡韦片组(75.00%,27/36)(P<0.05);耳穴磁疗+恩替卡韦片组、中药泡足+恩替卡韦片组总有效率高于恩替卡韦片组(P<0.05)。4组治疗后倦怠乏力、胁肋疼痛、脘腹胀闷、食欲不振、恶心呕吐、烦躁易怒、口干口苦评分均低于本组治疗前(P<0.05);耳穴磁疗+恩替卡韦片组治疗后胁肋疼痛、口干口苦评分低于恩替卡韦片组(P<0.05);中药泡足+恩替卡韦片组胁肋疼痛、脘腹胀闷、食欲不振、口干口苦评分低于恩替卡韦片组(P<0.05);耳穴磁疗+中药泡足+恩替卡韦片组胁肋疼痛、脘腹胀闷、食欲不振、恶心呕吐、口干口苦评分低于恩替卡韦片组(P<0.05),胁肋疼痛、脘腹胀闷、恶心呕吐评分低于耳穴磁疗+恩替卡韦片(P<0.05),口干口苦评分低于中药泡足+恩替卡韦片组(P<0.05)。4组治疗后ALT、AST水平均较本组治疗前降低(P<0.05);耳穴磁疗+恩替卡韦片组、中药泡足+恩替卡韦片组、耳穴磁疗+中药泡足+恩替卡韦片组治疗后ALT、AST水平均低于恩替卡韦片组(P<0.05)。耳穴磁疗+恩替卡韦片组治疗后腹部症状、乏力、Objective To observe the therapeutic effect of auricular point magnetic therapy combined with TCM foot bath on chronic hepatitis B(CHB)and its effect on TCM syndromes,liver function and life quality.Methods A total of 144 patients with CHB were randomly divided into 4 groups,36 in each group,Group 1(ear point magnetic therapy+entecavir tablets),Group 2(TCM foot bath+entecavir tablets),Group 3(ear point magnetic therapy+TCM foot bath+entecavir tablets),Group 4(entecavir tablets);24 weeks of treatment in four groups.It aimed to compare the efficacy of TCM syndromes,TCM syndrome scores changes,liver function alanine aminotransferase(ALT),aspartate aminotransferase(AST)levels,as well as chronic liver disease questionnaire(CLDQ)score changes in 4 groups before and after treatment.Results The total effective rate in Group 3(35.0%)was higher than that in Group 1(28.0%),Group 2(27.0%)and Group 4(20.0%),(P<0.05).Group 1 was not statistically different compared with Group 2(P>0.05).After treatment,the scores of fatigue,flank pain,abdominal distension,loss appetite,nausea and vomiting,irritability,dry mouth and bitter mouth in the four groups were all lower than those in this group before treatment(P<0.05);the scores of flank pain and dry mouth and bitter mouth in Group 1 were lower than those in Group 4(P<0.05);the scores of flank pain,abdominal distension,loss appetite,dry mouth and bitter mouth in Group 2 were lower than those in Group 4(P<0.05).The scores of flank pain,abdominal distension,loss appetite,nausea and vomiting,dry mouth and bitter mouth in Group 3 were lower than those in Group 4(P<0.05);the scores of flank pain,abdominal distension,nausea and vomiting in Group 3 were lower than those in Group 1(P<0.05);the scores of dry mouth and bitter mouth in Group 3 were lower than those in Group 2(P<0.05).The levels of ALT and AST after treatment in the four groups were lower than those before treatment in this group(P<0.05);the levels of ALT and AST after treatment in Group 1,Group 2,and Group 3 were lower than those
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