肝爽颗粒治疗湿邪蕴热型慢性乙型肝炎合并非酒精性脂肪肝的临床价值  

Clinical Value of Ganshuang Granule(肝爽颗粒)in Treatment of Chronic Hepatitis B Complicated with Non-Alcoholic Fatty Liver Due to Dampness and Heat Accumulation

作　　者：徐美灵 钟剑峰 李晓峰 张宪山 王伟洪 夏伟[2] XU Meiling;ZHONG Jianfeng;LI Xiaofeng;ZHANG Xianshan;WANG Weihong;XIA Wei(Firth School of Clinial Medicine of Zhejiang Chinese Medical University,Huzhou 313000,Zhejiang,China;The Seventh Peoples Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shangha 200120,China)

机构地区：[1]浙江中医药大学第五临床医学院(湖州市中心医院),浙江湖州313000 [2]上海中医药大学附属第七人民医院,上海200120

出　　处：《中华中医药学刊》2023年第11期70-73,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81873178);浙江省自然科学委员会实验动物项目(LGD20H190001)。

摘　　要：目的探讨肝爽颗粒治疗湿邪蕴热型慢性乙型肝炎合并非酒精性脂肪肝的临床价值。方法选择2019年6月—2022年6月88例确诊为湿邪蕴热型慢性乙型肝炎合并非酒精性脂肪肝的患者作为研究对象,采用随机数字法平均分为观察组与对照组两组,对照组给予恩替卡韦分散片及常规保肝治疗方案,观察组患者在对照组基础上联合肝爽颗粒治疗。随访观察3月比较两组临床疗程,并分别于治疗前、治疗后3月检测肝、肾功能、HBV-DNA水平及肝纤维化相关指标,并进行Child-Pugh评分,比较两组患者的差异。结果观察组总有效率90.91%(40/44)明显高于对照组75.00%(33/44),差异比较有统计学意义(P<0.05)。两组患者治疗后肝功能指标谷丙转氨酶(alanine aminotransferase,ALT)、谷草转氨酶(aspartate aminotransferase,AST)、白蛋白(Albumin,ALB)及总胆红素(Total bilirubin,TBil)较治疗前明显降低(P<0.05);治疗后观察组肝功能指标ALT、AST、ALB及TBil较对照组降低更明显(P<0.05)。两组患者治疗后HBV-DNA水平及CAP值较治疗前明显降低(P<0.05);治疗后观察组HBV-DNA水平及CAP值较对照组降低更明显(P<0.05)。两组患者治疗后肝纤维化四项指标均较治疗前明显降低(P<0.05);治疗后观察组肝纤维化四项指标均较对照组降低更明显(P<0.05)。结论联合肝爽颗粒治疗湿邪蕴热型慢性乙型肝炎合并非酒精性脂肪肝有更好的临床疗效,可以更好地促进肝功能恢复,降低肝脏脂肪变性及预防肝纤维化发生。Objective To investigate the clinical value of Ganshuang Granule(肝爽颗粒)in the treatment of chronic hepatitis B complicated with non-alcoholic fatty liver due to dampness and heat pathogen.Methods A total of 88 patients diagnosed with chronic hepatitis B complicated with non-alcoholic fatty liver disease due to dampness and heat accumulation from June 2019 to June 2022 were selected as the research subjects.They were equally divided into the observation group and the control group by using the random number method.The patients in the observation group were given entecavir dispersible tablets and routine liver-protecting treatment,while those in the observation group were given Ganshuang Granule in combination with the control group.The patients in the two groups were followed up for three months for comparison of clinical course.Liver and renal function,hepatitis B virus(HBV)-DNA level and liver fibrosis related indicators were detected before treatment and three months after treatment,and Child-Pugh score was performed to compare the differences between the two groups.Results The total effective rate of 90.91%in the observation group was significantly higher than that of 75.00%in the control group,and the difference was statistically significant(P<0.05).After treatment,liver function indexes such as alanine aminotransferase(ALT),aspartate aminotransferase(AST),albumin,(ALB)and total bilirubin(TBil)of patients in both groups were significantly lower than those before treatment(P<0.05).After treatment,the liver function indexes such as ALT,AST,ALB and TBil in the observation group were decreased more significantly than those in the control group(P<0.05).After treatment,HBV-DNA level and controlled attenuation parameter(CAP)value in patients of the two groups were significantly lower than those before treatment(P<0.05).After treatment,the levels of HBV-DNA and CAP in the observation group were significantly lower than those in the control group(P<0.05).The four indicators of liver fibrosis in patients of the

关 键 词：肝爽颗粒 湿邪蕴热型 慢性乙型肝炎 非酒精性脂肪肝 恩替卡韦 

分 类 号：R259.126[医药卫生—中西医结合] R259.755[医药卫生—中医内科学]