血府逐瘀汤联合恩替卡韦治疗瘀血阻络型乙型肝炎肝硬化代偿期患者的临床效果  

Clinical effect of Xuefu Zhuyu Decoction combined with entecavir for the treatment of patients with hepatitis B compensated liver cirrhosis in blood stasis and collaterals blocking type

作　　者：吴阳[1] 董汾 王克穷[2] 张锋利[1] 晁旭[3] 崔鹿 WU Yang;DONG Fen;WANG Keqiong;ZHANG Fengli;CHAO Xu;CUI Lu(The First Department of Gastroenterology,the Second Affiliated Hospital of Shaanxi University of Chinese Medicine,Xi’an 712000,Shaanxi,China;The Third Department of Oncology,the Second Affiliated Hospital of Shaanxi University of Chinese Medicine,Xi’an 712000,Shaanxi,China;Department of Scientific Research,the Second Affiliated Hospital of Shaanxi University of Chinese Medicine,Xi’an 712000,Shaanxi,China;Department of Internal Medicine,China Tibetology Research Center,Beijing Hospital of Tibetan Medicine,Beijing 100029,China)

机构地区：[1]陕西中医药大学第二附属医院消化一科,陕西省西安市712000 [2]陕西中医药大学第二附属医院肿瘤三科,陕西省西安市712000 [3]陕西中医药大学第二附属医院科研科,陕西省西安市712000 [4]中国藏学研究中心北京藏医院内科,北京市100029

出　　处：《广西医学》2024年第9期1366-1372,共7页Guangxi Medical Journal

基　　金：陕西省中医药管理局“双链融合”中青年科研创新团队建设项目(2022-SLRH-LJ-010,2022-SLRH-YQ-008);陕西省重点研发计划项目(2020ZDLSF05-13)。

摘　　要：目的 探讨血府逐瘀汤联合恩替卡韦治疗瘀血阻络型乙型肝炎肝硬化代偿期患者的临床效果。方法 选取80例瘀血阻络型乙型肝炎肝硬化代偿期患者,随机分为观察组和对照组,每组40例。给予观察组血府逐瘀汤联合恩替卡韦治疗,给予对照组恩替卡韦治疗,疗程均为24周。比较两组患者治疗前后失代偿期肝硬化发生率,HBV-DNA载量、肝功能[ALT、AST、总胆红素(TBIL)]、血清炎症因子[肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-6、IL-22]、肝脏超声相关指标(门静脉主干内径、脾静脉内径、脾脏厚度、脾脏长度)、中医证候积分和中医证候疗效的变化情况,以及治疗期间不良反应发生情况。结果 治疗后12周、治疗后24周,两组患者失代偿期肝硬化发生率及门静脉主干内径、脾静脉内径、脾脏厚度、脾脏长度差异无统计学意义(P>0.05)。两组患者的血清ALT、AST、TBIL、TNF-α、IL-6、IL-22水平,以及HBV-DNA载量、中医证候积分随治疗时间延长而降低,且治疗后12周、治疗后24周,观察组的上述指标均低于对照组(P<0.05)。治疗后,观察组的中医证候疗效的总有效率高于对照组(P<0.05)。治疗期间两组患者的不良反应发生率差异无统计学意义(P>0.05)。结论 血府逐瘀汤联合恩替卡韦治疗瘀血阻络型乙型肝炎肝硬化代偿期患者的临床疗效优于单纯恩替卡韦治疗,可有效降低炎症细胞因子的表达水平,改善肝功能,且安全性较好。Objective To explore the clinical effect of Xuefu Zhuyu Decoction combined with entecavir for the treatment of patients with hepatitis B compensated liver cirrhosis in blood stasis and collaterals blocking type.Methods A total of 80 patients with hepatitis B compensated liver cirrhosis in blood stasis and collaterals blocking type were selected,and they were randomly divided into observation group or control group,with 40 cases in each group.The observation group was treated with Xuefu Zhuyu Decoction combined with entecavir,while the control group was treated with entecavir.Both groups received 24-week course of treatment.The incidence rate of decompensated liver cirrhosis,HBV-DNA carrying capacity,liver function with respect to ALT,AST,total bilirubin(TBIL),serum inflammatory factors in terms of tumor necrosis factorα(TNF-α),interleukin(IL)-6,IL-22,liver ultrasound related indices(inner diameter of the main portal vein,splenic vein inner diameter,splenic thickness,splenic length),Traditional Chinese Medicine syndrome score and Traditional Chinese Medicine syndrome efficacy before and after treatment,as well as the occurrence of adverse reactions during treatment were compared debetween patients of the two groups.Results There was no statistically significant difference in the incidence rate of decompensated liver cirrhosis,inner diameter of the main portal vein,splenic vein inner diameter,splenic thickness,and splenic length between patients of the two groups 12 and 24 weeks after treatment(P>0.05).The levels of serum ALT,AST,TBIL,TNF-α,IL-6,IL-22,and HBV-DNA carrying capacity,Traditional Chinese Medicine syndrome score decreased with the prolonging of treatment time.After 12 and 24 weeks of treatment,the aforementioned indices in the observation group were lower than those in the control group(P<0.05).After treatment,the total effective rate of Traditional Chinese Medicine syndrome efficacy of the observation group was higher than that of the control group(P<0.05).There was no statistically significant diff

关 键 词：乙型肝炎肝硬化 代偿期 血府逐瘀汤 恩替卡韦 HBV-DNA 肝功能 血清炎症因子 

分 类 号：R573.1[医药卫生—消化系统]