两种治法治疗慢性乙肝肝郁脾虚证疗效比较

Comparison of Treating Shaoyang Zheng by Mediation and Dispersing Liver and Invigorating Spleen in Treating Stagnation of Liver-Qi and Deficiency of Spleen in Chronicity HBV

目的:观察和解少阳法与疏肝健脾法联合拉米呋啶治疗慢性乙肝肝郁脾虚证对乙肝病毒标志物的影响。方法:将慢性乙肝HBsAg与HBeAg同时阳性、中医辨证为肝郁脾虚证的患者132例随机分为和解少阳法(治疗组)70例和疏肝健脾法(对照组)62例,疗程1年。治疗过程中每隔1个月复查肝功能和HBV-DNA(HBV-DNA转阴后每隔2个月复查);乙肝三系每隔2个月检查1次。HBV-DNA或肝功能有波动者查YMDD变异,并作对比分析。结果:两组肝功能复常率、HBV-DNA转阴时间比较,差异无显著性意义(P>0.05);1年后HBeAg转阴率、转换率,YMDD变异率,治疗组70例中分别为31例(44.3%)、28例(40%)、3例(4.3%);对照组62例中分别为15例(24.2%)、13例(21%)、11例(17.7%),两组比较,差异均有显著性意义(P<0.05)。结论:和解少阳法联合拉米呋啶对HBeAg转阴、HBeAg转换、减少YMDD变异有较好疗效;和解少阳中药对慢性乙肝病毒标志物有一定的影响。

Objective：To obverse the effect of treating Shaoyang Zheng by mediation and dispersing liver and invigorating spleen combined with Lamivudine in treating stagnation of liver-qi and deficiency of spleen in chronicity HBV and the influence on virus symbol. Methods ：132 cases of chronicity HBV with positive HBsAg and HBeAg were defined as stagnation of liver-qi and deficiency of spleen and were randomly divided into the Shaoyang Zheng by mediation treatment group （70 cases） and the dispersing liver and invigorating spleen contrast group （62 cases）. During the period of treatment with 1 year, the liver function and HBV-DNA were observed each month and every two months after HBV-DNA turned negative. The HBV antigen system was checked every two months. The variation of YMDD was also examined if liver function or HBV- DNA was undulate. Results：The difference of the ratio of liver function recuperated and the time of HBV-DNA turned negative in two groups had no significant meaning （P 〉 0.05）. The cases of HBsAg turned negative, HBeAg turned negative, and YMDD varied in 70 cases of the treatment group after 1 year were 31, 28, 3 and the ratios were 44. 3%, 40% and 4.3% respectively. The cases of HBsAg turned negative, HBeAg turned negative, and YMDD varied in 62 cases of the contrast group after 1 year were 15, 13, 11 and the ratios were 24.2%, 21% and 17.7% respectively. The difference of two groups had significant meaning （P 〈 0.05 ）. Conclusion： Treating Shaoyang Zheng by mediation combined with Lamivudine has good effect on HBsAg and HBeAg turning to negative and reducing the variation ratio of YMDD. The traditional Chinese medicine of treating Shaoyang Zheng by mediation has some influence on virus symbol of chronicity HBV.