茵陈蒿汤加味联合恩替卡韦治疗肝胆湿热证HBeAg阳性慢性乙型肝炎7年疗效分析  

The observation of clinical effect of combined treatment of combined Artemisiae Capillariae Decoction and Entecavir on HBeAg positive Chronic Hepatitis B with damp-heat in liver and gallbladder for seven Years

作　　者：宋尘悦 陈建杰[1,2] 凌琪华 商斌仪[1,2] SONG Chen-yue;CHEN Jian-Jie;LING Qi-hua(Department of Hepatopathy,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai,201203,China)

机构地区：[1]上海中医药大学附属曙光医院肝病科,上海201203 [2]陈建杰全国名老中医药专家传承工作室

出　　处：《中西医结合肝病杂志》2023年第7期588-591,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：国家自然科学基金(No.82004321);上海市卫健委中医药发展基金(No.2018LP035);上海市名老中医学术经验工作室建设项目(No.ZYSNXD-CC-MZY003);第五批全国中医临床优秀人才研修项目。

摘　　要：目的:研究茵陈蒿汤加味联合恩替卡韦治疗HBeAg阳性慢性乙型肝炎肝胆湿热证患者的临床疗效。方法:采用回顾性研究的方法,收集符合纳入标准的68例HBeAg阳性慢性乙型肝炎肝胆湿热证患者的临床资料,根据不同治疗方式分为两组,治疗组患者34例采用茵陈蒿汤加味联合恩替卡韦治疗,对照组患者34例仅用恩替卡韦治疗。比较治疗84个月(7年)时,两组患者HBeAg、HBV DNA、HBsAg变化及患者出现肝硬化百分比的情况。结果:治疗结束时两组患者HBeAg、HBV DNA、HBsAg均较治疗前明显降低;治疗第12个月、48个月、60个月、72个月、84个月时,治疗组患者HBeAg阴转率分别为:17.6%、35.3%、44.1%、47.1%、55.9%,高于对照组的2.9%、11.8%、20.6%、23.5%、26.5%,差异具有统计学意义(P<0.05);治疗第48个月、60个月、72个月、84个月时,治疗组患者HBeAg血清转换率分别为:23.5%、29.4%、29.4%、32.4%,高于对照组的2.9%、5.9%、8.8%、11.8%,差异具有统计学意义(P<0.05);治疗84个月时,治疗组患者出现肝硬化的百分比为0%,对照组患者则为11.8%,差异具有统计学意义(P<0.05)。结论:茵陈蒿汤加味联合恩替卡韦治疗慢性乙型肝炎肝胆湿热证患者可提高其HBeAg阴转率、HBeAg血清转换率,在一定程度上可减少或延缓肝硬化的发生。Objective:To study the clinical effect of Added Yinchenhao Decoction combined with Entecavir on HBeAg positive Chronic Hepatitis B(damp-heat syndrome of liver and gallbladder)in seven years.Methods:A total of 68 patients with HBeAg-positive Chronic Hepatitis B(damp-heat The 0bsyndrome of liver and gallbladder)were included in this study by retrospective study.According to the treatment methods,34 patients in the treatment group were treated with Added Yinchenhao Decoction plus Entecavir,and 34 patients in the control group were treated with Entecavir only.After 84 months of treatment,the changes in HBeAg,HBV DNA,HBsAg,and Percentage of cirrhosis were observed.Results:①HBeAg,HBV DNA,and HBsAg in two groups were significantly lower than before treatment.②At 12,48,60,72,and 84 months after treatment,HBeAg negative conversion rates in the treatment group were as follows:17.6%,35.5%,44.1%,47.1%,55.9%,higher than 2.9%,11.8%,20.6%,23.5%,26.5%of the control group,the difference was statistically significant(P<0.05).③At 48,60,72 and 84 months after treatment,the serum conversion rates of HBeAg in the treatment group were 23.5%,29.4%,29.4%,and 32.4%,respectively,which were higher than those in the control group(2.9%,5.9%,8.8%,and 11.8%),with statistical significance(P<0.05).④The percentage of cirrhosis in the treatment group was 0%,lower than that in the control group(11.8%),and the difference was statistically significant at the 84 th month(P<0.05).Conclusion:Added Yinchenhao Decoction combined with Entecavir in the treatment of Chronic Hepatitis B can increase HBeAg negative conversion rate and HBeAg serum conversion rate and maybe could reduce or delay the occurrence of cirrhosis to a certain extent.

关 键 词：肝炎 乙型 慢性 茵陈蒿汤加味 恩替卡韦 

分 类 号：R575.1[医药卫生—消化系统]