慢性乙型肝炎84例中药辨证治疗疗效观察

Effect of TCM Treatment Based on Different Symptoms and Signs in 84 Patientis with Chronic Hepatitis B

目的观察中药辨证论治治疗慢性乙型肝炎的疗效。方法采用病例自身前后对照方法,以中药辨证论治治疗慢性乙型肝炎患者84例,疗程6个月,随访3个月,观察患者治疗前后及随访期间肝功能,血清HBsAg,HBeAg,HBV-DNA阴转率及症状体征的变化。结果治疗3个月、6个月、随访3个月ALT复常率分别为53.6%,66.7%,90.5%。在治疗6个月后,有4例患者HBsAg血清学阴转,1例患者出现HBsAg血清学转换。治疗6个月后,HBeAg血清学转换率为6.81%。HBV DNA的阴转率随治疗时间及随访时间而增加。治疗3个月后,患者证候疗效显效率为29.8%,有效率为63.1%,总有效率达92.9%。治疗6个月后,患者证候疗效痊愈率为1.2%,显效率75.9%,总有效率达97.1%。治疗结束后3个月随访,证候临床治愈率为25.6%,显效率为68.3%,总有效率为97.6%。结论中药在促使HBsAg阴转/血清学转换、HBeAg阴转/血清学转换,恢复肝功能、促进HBV DNA阴转、促进患者症状、体征的恢复上均有明显疗效。

Objective To observe the efficacy of TCM treatment based on different symptoms and signs in patients with chronic hepatitis B. Methods The autogenic control before and after study was used. The 84 patients with CHB were treated to receive TCM treatment based on pathogenesis obtained through different symptoms and signs. Patients were treated for 6 months and followed for an additional 3 months. The changes of liver function, negative conversion rate of HBsAg, HBeAg and HBV - DNA, symptoms and physical signs in patients were observed. Results ALT normalization rate in 3 months, 6months and followed 3 months was 53.6% ,66.7% and 90.5% respectively. Four patients in the TCM patients lost HBsAg and one had HBsAg serocon- version after 6 months treatment. The negative conversion rate of HBeAg was 6.81% after 6 months treatment. The negative conversion rate of HBV - DNA gradually increased in course of treatment. The clinical symptoms were improved more significantly after treatment than before treatment. Conclusion It is effective for TCM treatment in achieving virus loss and seroconversion, improving the liver funtion, clearing HBV DNA and improving symptoms and signs.