舒肝健脾法治疗乙肝后肝纤维化肝郁脾虚证临床观察  

Clinical Observation on Dispersing Stagnated Liver for Strengthening Spleen in the Treatment of Liver Fibrosis after Hepatitis B of Syndrome of Stagnation of Liver Qi and Spleen Deficiency

作　　者：李玲 王龙 LI Ling;WANG Long(Department of Hepatology of Integrated Traditional Chinese and Western Medicine,Fushun Infectious Diseases Hospital,Liaoning Province,Fushun 210411,China;91126 Military People’s Hospital,Liaoning province,Dalian 116041,China)

机构地区：[1]抚顺市传染病医院中西医结合肝病科,辽宁抚顺210411 [2]91126部队人民医院,辽宁大连116041

出　　处：《中国中医药现代远程教育》2021年第14期136-138,共3页Chinese Medicine Modern Distance Education of China

摘　　要：目的探讨中药联合恩替卡韦治疗乙肝后肝纤维化的临床效果。方法选取2017年7月—2019年10月在抚顺市传染病医院接受治疗的78例肝郁脾虚型乙肝后肝纤维化患者,由计算机编号,按照单双数法分为对照组(39例)和观察组(39例)。对照组采用恩替卡韦治疗,观察组在对照组基础上联合自拟肝郁脾虚证方治疗。比较2组患者的治疗效果、肝功能、血清肝纤维化指标。结果观察组患者的治疗总有效率为94.87%(37/39),高于对照组的79.49%(31/39),差异有统计学意义(P<0.05);观察组治疗后的丙氨酸氨基转移酶(Alanine aminotransferase,ALT)、总胆红素(Total bilirubin,TBIL)及天门冬氨酸氨基转移酶(Aspartate aminotransferase,AST)水平低于对照组,白蛋白(Albumin,ALB)高于对照组,差异有统计学意义(P<0.05);观察组治疗后的透明质酸(Hyaluronic acid,HA)、层粘连蛋白(Laminin,LN)、Ⅳ型胶原(IV collagen,IV-C)、Ⅲ型前胶原(TypeⅢprocollagen,PC-Ⅲ)均低于对照组,差异有统计学意义(P<0.05)。结论采用自拟肝郁脾虚证方联合恩替卡韦治疗乙肝后肝纤维化,可提高患者的治疗效果,改善患者的各项临床指标,值得临床推广。Objective To investigate the effect of self-made syndrome of stagnation of liver qi and spleen deficiency prescription combined with entecavir in the treatment of liver fibrosis after hepatitis B.Methods A total of 78 patients with liver fibrosis after hepatitis B who were treated in Fushun Infectious Diseases Hospital from July 2017 to October 2019 were selected by computer and were divided into control group(n=39)and observation group(n=39).The control group was treated with entecavir,and the observation group was treated with self-made syndrome of stagnation of liver qi and spleen deficiency prescription combined with entecavir.The therapeutic effect,liver function and serum indexes of liver fibrosis were compared between the two groups.Results The total effective rate of observation group was 94.87%(37/39),which was higher than that of control group 79.49%(31/39),and the difference was statistically significant(P<0.05).Alanine aminotransferase(ALT),Total bilirubin(TBIL)and Aspartate in the observation group after treatment Aminotransferase(AST)level was lower than control group,Albumin(ALB)was higher than control group,the difference was statistically significant(P<0.05);Hyaluronic acid(HA),Laminin(LN),IV collagen(IV-C)and TypeⅢprocollagen(TypeⅢ)were observed in the treatment group Procollagen II,PC-Ⅲ)were lower than those of the control group,and the difference was statistically significant(P<0.05).Conclusion The self-made syndrome of stagnation of liver qi and spleen deficiency prescription combined with entecavir in the treatment of liver fibrosis after hepatitis B can significantly improve the clinical symptoms of patients and adjust their liver function and fibrosis indexes to return to normal.

关 键 词：乙肝 肝纤维化 肝郁脾虚证 恩替卡韦 肝功能 中西医结合疗法 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]