补肾化瘀汤联合恩替卡韦治疗乙型肝炎肝硬化代偿期患者临床研究  

Clinical observation on the effect of Bushen Huayu decoction in the treatment of compensatory patients with hepatitis B cirrhosis

作　　者：冯丽娟 周晓玲 阮博文 李灿 沈新辉 FENG Li-juan;ZHOU Xiao-ling;RUAN Bo-wen(Graduate School of Guangxi University of Traditional Chinese Medicine(Nanning Guangxi,530200),China;不详)

机构地区：[1]广西中医药大学研究生院,广西南宁530200 [2]柳州市中医医院(柳州市壮医医院)消化内科

出　　处：《中西医结合肝病杂志》2023年第1期29-31,35,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：国家自然科学基金项目(No.81760855);柳州市科学技术局科技计划项目(No.2018AF10503);医学科研发展基金项目(No.B21051DS);广西中医药大学2020年校级硕士研究生科研创新项目(No.YCSY20200057)。

摘　　要：目的:观察补肾化瘀汤联合恩替卡韦治疗乙型肝炎肝硬化代偿期患者临床疗效。方法:100例脾肾阳虚夹瘀证乙型肝炎肝硬化代偿期患者,按随机数字表法分为对照组和治疗组,各50例。两组患者均口服恩替卡韦胶囊,0.5 mg/次,1次/d;治疗组患者加服补肾化瘀汤。1个月为1个疗程,两组患者均治疗6个疗程。治疗结束时比较两组患者的中医证候积分、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBil)、白蛋白(Alb)、血清HBV DNA转阴率、透明质酸(HA)、层黏连蛋白(LN)、Ⅲ型前胶原蛋白(PCⅢ)、Ⅳ型胶原蛋白(Ⅳ-C)、肝脏硬度值、门静脉内径、脾静脉内径、脾脏厚度及长度等指标的变化,比较两组患者临床疗效。结果:治疗结束时,治疗组患者中医证候积分低于对照组,差异有统计学意义(P<0.05);而ALT、AST、TBil水平及血清HBV DNA转阴率与对照组比较,差异无显著性意义(P>0.05),但Alb水平高于对照组,差异有统计学意义(P<0.05)。治疗6个月时治疗组患者的HA、LN、PCⅢ、Ⅳ-C水平明显低于对照组,差异有显著性意义(P<0.05),而肝脏硬度值、门静脉内径、脾静脉内径、脾脏厚度及长度明显低于对照组,差异亦有统计学意义(P<0.05)。治疗组患者的临床疗效比对照组好,差异有显著性意义(P<0.05)。治疗期间两组患者均末出现不良反应。结论:补肾化瘀汤联合恩替卡韦治疗乙型肝炎肝硬化代偿期患者临床疗效显著,能改善患者肝功能,降低肝硬化程度,明显改善临床症状,提高其生活质量,值得临床推广运用。Objective:To observe the clinical efficacy of Bushenhuayu Decoction in the treatment of compensatory patients with hepatitis B cirrhosis.Methods:A total of 100 patients with liver cirrhosis at the compensatory stage of spleen-kidney Yang deficiency syndrome and blood stasis syndrome were randomly divided into control group and treatment group according to random number table,50 cases in each group.The control group was treated with an entecavir capsule,0.5 mg/time,once a day.The treatment group was supplemented with Bushen Huayu Decoction on the basis of the treatment in the control group.The course of treatment in both groups was six months.After the course of treatment,TCM syndrome score,TCM clinical efficacy,ALT,AST,total bilirubin(TBil),albumin(ALB),serum HBV DNA negative conversion rate,hyaluronic acid(HA),laminin(LN),Ⅲtype procollagen(PCⅢ),ⅣCollagen typeI(Ⅳ-C),liver hardness value,portal vein diameter,splenic vein diameter,spleen thickness,spleen length,and other indexes were compared between the two groups.Results:After treatment,the TCM syndrome score in the treatment group was lower than that in the control group(P<0.05),and the clinical efficacy of TCM in the treatment group was higher than that in the control group(P<0.05).The ALT,AST,TBil levels,and serum HBV DNA nega-tive conversion rate in the treatment group were not significantly different from those in the control group(P>0.05),but ALB level in the treatment group was higher than that in the control group(P<0.05).The levels of HA,LN,PCⅢandⅣ-C in the treatment group were significantly lower than those in the control group(P<0.05).The hardness value of the liver,the inner diameter of the portal vein,the inner diameter of splenic vein,thickness,and length of the spleen in the treatment group were significantly lower than those in the control group(P<0.05).There were no adverse reactions in the two groups during the treatment.Conclusion:Bushen Huayu Decoction has significant clinical efficacy in the treatment of compensatory patients with

关 键 词：补肾化瘀汤 乙型肝炎肝硬化代偿期 脾肾阳虚夹瘀证 临床疗效 

分 类 号：R575.2[医药卫生—消化系统]