健脾清化方联合恩替卡韦治疗乙肝肝硬化的疗效研究  

Therapeutic effect of Jianpi Qinghua decoction combined with entecavir on Hepatitis B cirrhosis

作　　者：刘三海 陈靓[1] 金若珏 胡倩倩 朱小区[1] LIU Sanhai;CHEN Liang;JIN Ruojue(Department of Hepatology,Wenzhou TCM Hospital of Zhejiang Chinese Medical Universi-ty,Wenzhou 325000,China)

机构地区：[1]浙江中医药大学附属温州市中医院肝病科,浙江温州325000

出　　处：《全科医学临床与教育》2025年第1期31-34,共4页Clinical Education of General Practice

基　　金：温州市基础性科研项目(2020Y0206)。

摘　　要：目的探讨健脾清化方联合恩替卡韦治疗乙肝肝硬化的疗效。方法选取98例乙肝肝硬化患者,随机分为研究组49例和西药组49例,西药组患者接受恩替卡韦治疗,研究组患者接受健脾清化方联合恩替卡韦治疗,连续治疗12周后,比较两组临床疗效、中医症状积分、肝功能、肝纤维化和不良反应情况。结果研究组总有效率明显高于西药组(χ^(2)=4.35,P<0.05);研究组患者中医症状积分、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、透明质酸(HA)、层黏蛋白(LN)、Ⅲ型前胶原(PCⅢ)水平均明显低于西药组(t分别=-3.19、-3.61、-10.44、-4.79、-3.43、-2.71、-3.91,P均<0.05);两组不良反应比较,差异无统计学意义(χ^(2)=0.12,P>0.05)。结论健脾清化方辅助恩替卡韦治疗乙肝肝硬化可进一步减轻中医症状,改善肝功能和肝纤维化,且安全性良好。Objective To investigate the therapeutic effect of Jianpi Qinghua decoction combined with entecavir on hepatitis B cirrhosis.Methods A total of 98 patients with Hepatitis B cirrhosis were randomly divided into a combination group(49 cases)and a western medicine group(49 cases).Patients in the Western medicine group received entecavir treatment,and the combined group received Jianpi Qinghua decoction combined with entecavir treatment.After 12 weeks of continuous treatment,the clinical efficacy,TCM symptom score and liver function of the two groups were compared.Results The total effective rate of combination group was significantly higher than western medicine group(χ^(2)=4.35,P<0.05).After treatment,the TCM symptom score,ALT,AST,TBIL,HA,LN and PCⅢlevels of the combination group were lower than the western medicine group(t=-3.19,-3.61,-10.44,-4.79,-3.43,-2.71,-3.91,P<0.05).There was no significant difference in adverse incidence between two groups(χ^(2)=0.12,P>0.05).Conclusion Jianpi Qinghua decoction combined with entecavir has a remarkable effect in the adjuvant treatment of chronic hepatitis B,which can further relieve TCM symptoms,improve liver function and liver fibrosis,and has good safety.

关 键 词：乙肝肝硬化 湿热蕴结 健脾清化方 恩替卡韦 肝功能 肝纤维化 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]