通络消癥汤联合恩替卡韦胶囊治疗肝郁脾虚夹瘀证乙型肝炎肝硬化失代偿期的效果  

Effect of Tongluo Xiaozheng Decoction combined with Entecavir Capsules in the treatment of decompensated stage of hepatitis B cirrhosis due to liver stagnation and spleen deficiency with blood stasis

作　　者：唐聪 刘成 TANG Cong;LIU Cheng(Department of Hepatology,Bijie Traditional Chinese Medicine Hospital,Guizhou Province,Bijie551700,China)

机构地区：[1]贵州省毕节市中医医院肝病科,贵州毕节551700

出　　处：《中国当代医药》2024年第4期124-128,共5页China Modern Medicine

基　　金：贵州省中医药管理局中医药、民族医药科学技术研究课题(QZYY-2019-078)。

摘　　要：目的探讨通络消癥汤联合恩替卡韦胶囊治疗肝郁脾虚夹瘀证乙型肝炎肝硬化失代偿期的效果。方法选取2019年1月至2022年12月毕节市中医医院收治的100例肝郁脾虚夹瘀证乙型肝炎肝硬化失代偿期患者作为研究对象,按照随机数字表法分为观察组(50例)与对照组(50例),对照组采用恩替卡韦胶囊治疗,观察组采用通络消癥汤联合恩替卡韦胶囊。比较两组的临床疗效、预后效果、肝功能、中医证候积分、临床指标。结果观察组的总有效率高于对照组,差异有统计学意义(P<0.05);观察组乙型肝炎病毒DNA(HBV-DNA)转阴率、乙型肝炎病毒e抗原(HBeAg)转阴率高于对照组,差异有统计学意义(P<0.05);观察组的谷丙转氨酶(ALT)、总胆红素(TBil)、透明质酸酶(HA)低于对照组,白蛋白(ALB)高于对照组,差异有统计学意义(P<0.05);观察组的腹大坚满、肋腹疼痛、脉络怒张、大便色黑等积分低于对照组,差异有统计学意义(P<0.05);观察组的门静脉内径、脾厚度小于对照组,差异有统计学意义(P<0.05)。结论在乙型肝炎肝硬化失代偿期治疗中,选择通络消癥汤联合恩替卡韦胶囊的方案既可改善其肋腹疼痛等症状,亦可促进其肝功能恢复,通过提高HBV-DNA转阴率,达到控制患者病情的目的,值得借鉴与实施。Objective To investigate the effect of Tongluo Xiaozheng Decoction combined with Entecavir Capsules in the treatment of decompensated stage of hepatitis B cirrhosis due to liver stagnation and spleen deficiency with blood stasis.Methods A tatal of 100 patients with decompensated hepatitis B cirrhosis of liver stagnation and spleen deficiency with blood stasis syndrome who were treated in the Bijie Traditional Chinese Medicine Hospital from January 2019 to December 2022 were selected as the research subjects.According to the random number table method,they were divided into an observation group and a control group with 50 cases in each group.The control group was treated with Entecavir Capsules,and the observation group were treated with Tongluo Xiaozheng Decoction combined with Entecavir Capsules.The clinical effect,prognostic effect,liver function,Traditional Chinese Medicine syndrome score and clinical indexes were compared between the two groups.Results The total effective rate of observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).The negative conversion rates of hepatitis B virus DNA(HBV-DNA)and hepatitis B e antigen(HBeAg)in observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The alanine aminotransferase(ALT),total bilirubin(TBil)and hyaluronidase(HA)in observation group were lower than those in the control group,and albumin(ALB)was higher than that in the control group,and the differences were statistically significant(P<0.05).The scores of abdominal fullness,costal/abdominal pain,distended veins,and dark stool in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The inner diameter of the portal vein and spleen thickness in the observation group were smaller than those in the control group,and the differences were statistically significant (P<0.05). Conclusion In treatment for hepatitis B cirrhosis at

关 键 词：通络消癥汤 恩替卡韦胶囊 乙型肝炎 肝硬化 失代偿期 肝郁脾虚夹瘀证 

分 类 号：R575.2[医药卫生—消化系统] R512.62[医药卫生—内科学]