慢性乙型肝炎湿热瘀毒证中西医结合治疗的临床及机制研究

Clinical and mechanism study of traditional Chinese medicine combined with western medicine on wetness-heat and toxic stasis syndromes of chronic hepatitis B

目的观察名老中医方化肝解毒汤联合替比夫定治疗湿热瘀毒证之慢性乙型肝炎后病毒血清学和肝脏病理学改变情况。方法将42例慢性乙型肝炎患者随机分成2组:对照组予替比夫定100 mg/d口服,疗程1 a以上,治疗组在口服替比夫定100 mg/d的基础上加服化肝解毒汤,治疗12周,然后单用替比夫定,疗程1 a以上。观察2组治疗12周后肝脏病理组织学及临床症状、肝功能及HBV-DNA、肝纤维化指标的改变情况。结果治疗12周后,治疗组肝组织改善程度明显优于对照组,临床症状、肝功能、血清纤维化指标与对照组比较也显著改善。结论化肝解毒汤联合替比夫定治疗慢性乙型肝炎近期疗效显著。

Objective It is to observe the changes of virus serology and liver pathology after the treatment with Huagan Jiedu decoction which was made by a notable old traditional Chinese medical doctor combined with Telbivudine for wetnessheat and toxic stasis syndromes of hepatitis B. Methods 42 patients with chronic hepatitis B were randomly divided into 2 groups： the control group was only given Telbivudine 100 mg/d by oral use. The treatment course was above one year. The treatment group was added with Huagan Jiedu decoction for 12 weeks on the basis of treatment with Telbivudine 100 mg/d, then only given Telbivudine. The treatment course was also one year. The changes of liver pathology, liver function and HBV-DNA, indexes of hepatic fibrosis were observed after 12 weeks＇ treatment in both groups. Results The improvement of liver tissue in treatment group was significantly better than that in control group. Compared with control group, clinical symptoms, liver function and serum hepatic fibrosis indexes were improved more in treatment group. Conclusion Huagan Jiedu decoction has a significant recent curative effect on chronic hepatitis B.