疏肝健脾化瘀汤联合恩替卡韦治疗肺结核合并慢性乙型病毒性肝炎患者的效果  

Effects of Shugan Jianpi Huayu decoction combined with Entecavir in treatment of pulmonary tuberculosis complicated with chronic hepatitis B

作　　者：蔡琪 徐密琴 CAI Qi;XU Miqin(Department of Infectious Diseases of Suzhou Ninth People’s Hospital,Suzhou 215000 Jiangsu,China)

机构地区：[1]苏州市第九人民医院感染科,江苏苏州215000

出　　处：《中国民康医学》2024年第24期82-85,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察疏肝健脾化瘀汤联合恩替卡韦治疗肺结核合并慢性乙型病毒性肝炎(CHB)患者的效果。方法:选取2021年9月至2023年9月该院收治的81例肺结核合并CHB患者进行前瞻性研究,根据随机数字表法将其分为对照组41例与研究组40例。对照组采用恩替卡韦口服治疗,研究组在对照组基础上联合疏肝健脾化瘀汤治疗,比较两组治疗效果,治疗前后肝功能指标[天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)]、肝纤维化指标[Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)、透明质酸(HA)、层粘连蛋白(LN)]、凝血功能指标[凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)]水平,以及不良反应发生率。结果:研究组病灶吸收率、痰涂片转阴率、乙型肝炎病毒转阴率均高于对照组,差异有统计学意义(P<0.05);两组ALT、TBIL、AST水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组PCⅢ、Ⅳ-C、HA、LN水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组TT、APTT、PT水平均低于治疗前,且研究组低于对照组,两组FIB水平均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:疏肝健脾化瘀汤联合恩替卡韦治疗肺结核合并CHB患者可提高病灶吸收率、痰涂片转阴率和乙型肝炎病毒转阴率,改善凝血功能指标水平,以及降低肝功能指标和肝纤维化指标水平的效果优于单纯恩替卡韦口服治疗。Objective:To observe effects of Shugan Jianpi Huayu decoction combined with Entecavir in treatment of pulmonary tuberculosis complicated with chronic hepatitis B(CHB).Methods:A prospective study was conducted on 81 patients with pulmonary tuberculosis complicated with CHB admitted to the hospital from September 2021 to September 2023.According to the random number table method,they were divided into 41 cases in the control group and 40 cases in the study group.The control group was treated with Entecavir orally,while the study group was treated with Shugan Jianpi Huayu decoction on the basis of that of the control group.The therapeutic effect,the levels of liver function indexes[aspartate aminotransferase(AST),total bilirubin(TBIL),serum alanine aminotransferase(ALT)],the liver fibrosis indexes[type III procollagen(PCIII),type IV collagen(IV-C),hyaluronic acid(HA),laminin(LN)]and the coagulation function indexes[thrombin time(TT),activated partial thromboplastin time(APTT),prothrombin time(PT),fibrinogen(FIB)]before and after the treatment,and the incidence of adverse reactions were compared between the two groups.Results:The lesion absorption rate,the sputum smear negative conversion rate and the hepatitis B virus negative conversion rate in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).The levels of ALT,TBIL and AST in the two groups were lower than those before the treatment,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of PCIII,IV-C,HA and LN in the two groups were lower than those before the treatment,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of TT,APTT and PT in the two groups were lower than those before the treatment,and those in the study group were lower than those in the control group;the FIB levels of the two groups were higher than those before

关 键 词：疏肝健脾化瘀汤 恩替卡韦 肺结核 慢性乙型病毒性肝炎 肝功能 肝纤维化 凝血功能 

分 类 号：R512.6[医药卫生—内科学]