柴胡解毒汤联合恩替卡韦治疗慢性乙型肝炎的临床观察  

Clinical effect of Chaihu Jiedu decoction combined with entecavir in the treatment of chronic hepatitis B

作　　者：路秀萍 李文[1] 易爱芬 毋玥 Lu Xiuping;Li Wen;Yi Aifen;Wu Yue(Department of Hepatology,Anyang Fifth People’s Hospital,Anyang 455000,China)

机构地区：[1]安阳市第五人民医院肝病科,安阳455000

出　　处：《中国实用医刊》2022年第15期116-119,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨柴胡解毒汤联合恩替卡韦治疗慢性乙型肝炎(CHB)的疗效。方法抽取2019年4月至2020年4月安阳市第五人民医院收治的CHB患者88例,按随机数字表法分成观察组和对照组,每组44例。两组均实施常规干预及治疗,在此基础上,对照组应用恩替卡韦治疗,观察组应用柴胡解毒汤联合恩替卡韦治疗,两组均治疗12个月。比较两组治疗12个月时临床疗效及乙型肝炎病毒DNA(HBV-DNA)转阴率;比较两组治疗前后肝功能指标[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)]及T淋巴细胞亚群(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平。结果治疗结束时,观察组总有效率(97.73%,43/44)高于对照组(81.82%,36/44),P<0.05。治疗结束时,两组血清ALT、AST、TBIL水平均低于治疗前,且观察组低于对照组(P<0.05)。治疗结束时,两组CD8^(+)均低于治疗前,CD4^(+)、CD4^(+)/CD8^(+)均高于治疗前,且观察组CD8^(+)低于对照组,CD4^(+)、CD4^(+)/CD8^(+)均高于对照组(P均<0.05)。治疗12个月,观察组HBV-DNA转阴率(95.45%,42/44)高于对照组(81.82%,36/44),P<0.05。结论柴胡解毒汤联合恩替卡韦治疗可改善CHB患者肝功能指标,调节机体免疫功能,提高临床疗效,促进HBV-DNA转阴。Objective To investigate the efficacy of Chaihu Jiedu decoction combined with entecavir in the treatment of chronic hepatitis B(CHB).Methods Eighty-eight patients with CHB treated in Anyang Fifth People’s Hospital from April 2019 to April 2020 were selected.They were divided into observation group and control group by random number table method,with 44 cases in each group.Routine intervention and treatment were performed on both groups,on this basis,the control group was treated with entecavir,and the observation group was treated with Chaihu Jiedu decoction combined with entecavir.Both groups were treated for 12 months.The clinical efficacy and hepatitis B virus DNA(HBV-DNA)negative conversion rate of the two groups were compared after 12 months of treatment.Before treatment and after treatment,the indexes of liver function,including alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBIL),and the levels of T lymphocyte subsets including cluster of differentiation 4^(+)(CD4^(+)),cluster of differentiation 8^(+)(CD8^(+))and CD4^(+)/CD8^(+)were compared between the two groups.Results At the end of treatment,the total effective rate of the observation group(97.73%,43/44)was higher than that of the control group(81.82%,36/44),P<0.05.At the end of treatment,the levels of serum ALT,AST and TBIL in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(P<0.05).At the end of treatment,CD8^(+)of the two groups were decreased,CD4^(+)and CD4^(+)/CD8^(+)were increased,compared with those indexes before treatment,while CD8^(+)in the observation group was lower than that in the control group,and CD4^(+)and CD4^(+)/CD8^(+)were higher than those in the control group(P<0.05).After 12 months of treatment,the negative conversion rate of HBV-DNA in the observation group was 95.45%(42/44),higher than 81.82%(36/44)in the control group(P<0.05).Conclusions Chaihu Jiedu decoction combined with entecavir can improve liver function

关 键 词：慢性乙型肝炎 柴胡解毒汤 恩替卡韦 T淋巴细胞亚群 

分 类 号：R512.62[医药卫生—内科学]