清热化湿方治疗HBeAg阳性慢性乙型肝炎

The treatment of HBeAg positive of chronic hepatitis B with Qingre Huashi Decoction

目的评估清热化湿方治疗HBeAg阳性慢性乙型肝炎的临床疗效。方法随机选取HBeAg阳性慢性乙型肝炎患者120例,随机分为治疗组及对照组各60例。治疗组采用清热化湿方(茵陈、苍术、白术、大黄、栀子、茯苓、车前子、半枝莲)联合恩替卡韦。对照组仅服用恩替卡韦治疗。分别观察患者治疗3个月、6个月、1年、1.5年、停服中药后1年的HBV-DNA定量、HBeAg的定量,测定肝功能及中医证候,以评估临床疗效。结果清热化湿方治疗组及对照组HBeAg转阴率分别为41.67%,21.67%,2组对比P<0.05。ALT复常率、中医证候的改善率比较,有统计学意义(P<0.05)。而2组的HBV-DNA转阴率分别为83.33%,73.33%,2组比较无统计学意义(P>0.05)。结论清热化湿方联合恩替卡韦治疗HBeAg阳性慢性乙型肝炎能有效地抑制乙肝病毒复制,提高HBeAg阴转率,减轻肝细胞炎症反应,促进肝细胞再生,恢复肝功能,改善临床证候,且临床上无明显不良反应。

Objective To evaluate the clinical efficacy of Qingre Huashi Decoction in the treatment of HBeAg positive chronic hepatitis B. Methods 120 cases of HBeAg positive patients with chronic hepatitis B were randomly selected, and were randomly divided into treatment group and control group with 60 cases in each. Treatment group were treated with Qin- gre Huashi Recipe （ Capillary artemisia, Atractylodes rhizome, largehead atractylodes rhizome, rhubarb, Gardenia, Poria, Plan- tago,Scutellaria barbara） combined with entecavir while the control group were taking entecavir therapy only. In order to e- valuate the clinical efficacy, patients were observed for 3 months, 6 months, 1 year, 1.5 years. HBV-DNA quantity for 1 year after stop taking the medicine and HBeAg quantity were also observed. What＇s more,liver function and TCM syndrome were determined to evaluate clinical effect. Results The negative rates of HBeAg of treatment group and control group of were 41.67% ,21.67% respectively （P 〈 0.05）. The comparison between the ALT recovery rate and symptom improvement shows that two groups were both P 〈 0.05, which shows that there was a significant difference. And the HBV-DNA negative rates of two groups were 83.33 %, 73.33 %, which show no significance （ P 〉 0.05）. Conclusion Qingre Huashi recipe combined with entecavir in the treatment of HBeAg positive chronic hepatitis B can effectively inhibit hepatitis B virus repli- cation, improve the negative rate of HBeAg, reduce the inflammation of liver ceils, promote the regeneration of liver cells, re- store liver function and improve clinical symptoms with no obvious clinical adverse reaction.