艾灸联合恩替卡韦治疗脾肾阳虚型慢性乙型肝炎临床研究  

Clinical Study on Moxibustion Combined with Entecavir for Chronic Hepatitis B of Spleen-Kidney Yang Deficiency Type

作　　者：刘三海 朱小区[1] 金若珏 陈靓[1] 叶小丹[1] 胡倩倩 LIU Sanhai;ZHU Xiaoqu;JIN Ruojue;CHEN Liang;YE Xiaodan;HU Qianqian(Wenzhou Hospital of Traditional Chinese Medicine,Wenzhou Zhejiang 325000,China)

机构地区：[1]温州市中医院,浙江温州325000

出　　处：《新中医》2023年第14期151-155,共5页New Chinese Medicine

基　　金：温州市医药卫生科研项目(2016ZB02);温州市基础性科研项目(Y2020941)。

摘　　要：目的:观察艾灸联合恩替卡韦治疗脾肾阳虚型慢性乙型肝炎(CHB)的临床疗效。方法:选取90例脾肾阳虚型CHB患者,按照随机数字表法分为对照组和治疗组各45例,治疗组4例因主动退出研究而脱落,最终纳入41例。对照组给予恩替卡韦分散片治疗,治疗组在对照组基础上予以艾灸治疗,2组均治疗3个月,随访6个月。比较2组临床疗效、中医证候积分、肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBil)]、T淋巴细胞亚群指标(CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)值)及不良反应发生率。结果:治疗后,治疗组临床疗效总有效率97.56%,高于对照组82.22%(P<0.05)。2组畏寒肢冷、腰膝酸软、食欲不振、倦怠乏力积分均较治疗前降低(P<0.05),治疗组上述4项中医证候积分均低于对照组(P<0.05)。2组ALT、AST、TBil水平均较治疗前降低(P<0.05),治疗组ALT、AST、TBil水平均低于对照组(P<0.05)。2组CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)值均较治疗前升高(P<0.05),治疗组CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)值均高于对照组(P<0.05)。对照组不良反应发生率8.89%,与治疗组9.76%比较,差异无统计学意义(P>0.05)。结论:在恩替卡韦治疗脾肾阳虚型CHB基础上加用艾灸可提高临床疗效,有效改善患者的临床症状和肝功能,调节免疫功能,安全性好。Objective:To observe the clinical effect of moxibustion combined with Entecavir for chronic hepatitis B(CHB)of spleen-kidney yang deficiency type.Methods:A total of 90 cases of CHB patients of spleen-kidney yang deficiency type were selected and divided into the control group and the treatment group according to the random number table method,with 45 cases in each group.Four cases in the treatment group were dropped out due to voluntary withdrawal from the study,and finally,41 cases were included in the treatment group.The control group was treated with Entecavir Dispersible Tablets,and the treatment group was additionally treated with moxibustion based on the treatment of the control group.Both groups were treated for 3 months,followed up for 6 months.Clinical effects,traditional Chinese medicine(TCM)syndrome scores,liver function indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST),and total bilirubin(TBil)],T lymphocyte subsets indexes(CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)values),and the incidence of adverse reactions were compared between the two groups.Results:After treatment,the total clinical effective rate was 97.56%in the treatment group,higher than that of 82.22%in the control group(P<0.05).The scores of intolerance to cold and cold limbs,soreness and weakness of waist and knees,poor appetite,and fatigue and lack of strength in the two groups were decreased when compared with those before treatment(P<0.05),and the above four TCM syndrome scores in the treatment group were lower than those in the control group(P<0.05).The levels of ALT,AST,and TBil in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of ALT,AST,and TBil in the treatment group were lower than those in the control group(P<0.05).The levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)values in the two groups were increased when compared with those before treatment(P<0.05),and the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)value in the treatment group were higher than those in the contro

关 键 词：慢性乙型肝炎 脾肾阳虚型 艾灸 恩替卡韦 中医证候 肝功能 T淋巴细胞亚群 

分 类 号：R512.62[医药卫生—内科学]