逍遥散加减联合替诺福韦治疗慢性乙肝肝纤维化(肝郁脾虚证)临床观察  

Curative effect of Modified Xiaoyao Powder combined with tenofovir on chronic hepatitis B liver fibrosis

作　　者：王万娥 张青[1] 王雨露 唐瑶[1] WANG Wan-e;ZHANG Qing;WANG Yu-lu;TANG Yao(Department of Hepatology,The Fourth People's Hospital of Huai'an,Huai'an 223002)

机构地区：[1]江苏省淮安市第四人民医院肝病科,江苏淮安223002

出　　处：《湖北中医药大学学报》2022年第5期28-31,共4页Journal of Hubei University of Chinese Medicine

基　　金：江苏省淮安市科技计划项目(项目编号:HAWJZ202103)。

摘　　要：目的 观察逍遥散加减联合替诺福韦治疗慢性乙肝(CHB)肝纤维化(肝郁脾虚证)临床疗效。方法将我院肝郁脾虚证慢性CHB(肝郁脾虚证)患者160例随机分为治疗组与对照组各80例。对照组采用替诺福韦治疗,治疗组采用逍遥散加减联合替诺福韦治疗。分别于治疗前后记录两组患者临床疗效、中医证候积分评分,记录两组肝功能指标谷草转氨酶(AST)、谷丙转氨酶(ALT)和总胆红素(TBIL)、肝纤维化指标[肝脏硬度值(LSM)、Ⅲ型前胶原(PC-Ⅲ)、层粘连蛋白(LN)、透明质酸(HA)、Ⅳ型胶原(IVC)]及乙肝病原学指标HBs Ag阴转率、HbeAg转换率。结果 治疗后,治疗组愈显率明显高于对照组(P<0.05);治疗组中医证候积分明显低于对照组(P<0.05);治疗组AST、ALT、TBIL、PC-Ⅲ、LN、HA、IVC水平和LSM值均明显低于对照组(P<0.05);治疗组HBsAg阴转率明显高于对照组(P<0.05),两组患者HBe Ag转换率差异不显著(P>0.05)。结论 逍遥散加减联合替诺福韦治疗CHB肝纤维化显示出良好的临床疗效,能够改善肝功能及乙肝病毒学指标,适合临床推广使用。Objective To observe the clinical effect of Modified Xiaoyao Powder combined with tenofovir in treatment of chronic hepatitis B(CHB)liver fibrosis. Methods A total of 160 patients with CHB(stagnation of liver-qi and deficiency of spleen)were randomly divided into treatment group and control group,80 cases each. Control group was treated with tenofovir,and treatment group was treated with Modified Xiaoyao Powder on the basis of control group. The effective rate and the scores of TCM syndrome were recorded before and after treatment,aspartate aminotransferase(AST),alanine aminotransferase(ALT),alanine transaminase(Tbil),liver fibrosis index(LSM),type III Procollagen(PC-Ⅲ),laminin,hyaluronic acid(HA),type Ⅳcollagen(ⅣC)and HBSAG negative conversion rate,HBEAG conversion rate were recorded. Results After treatment,the total effective rate of treatment group was significantly higher than that of control group( P<0.05),and the TCM syndrome scores of treatment group were significantly lower than that of control group( P<0.05);AST,ALT,TBIL,PC-Ⅲ,LN,Ha,ⅣC and Lsm levels in treatment group were significantly lower than those in control group( P<0.05),and the negative conversion rate of HBSAG was significantly higher in treatment group than in control group( P<0.05),there was no significant difference in HBEAG conversion rate between the two groups( P>0.05). Conclusion Modified Xiaoyao Powder combined with tenofovir,which can improve liver function and etiological indexes of hepatitis B,is significant on CHB liver fibrosis.

关 键 词：慢性乙肝 肝纤维化 逍遥散 随症加减治疗 替诺福韦 

分 类 号：R259[医药卫生—中西医结合]