疏肝健脾解毒方治疗肝郁脾虚型HBeAg阳性慢性HBV携带者168例的临床疗效

Clinical effect of traditional Chinese medicine in treating 168 cases of HBeAg positive chronic HBV carrier with liver stagnation and spleen deficiency syndrome

目的观察中医治疗肝郁脾虚型HBeAg阳性的慢性乙型肝炎病毒(HBV)携带者的临床疗效。方法选择HBeAg和HBV DNA阳性,1年内连续随访3次以上均显示血清ALT和AST在正常范围,伴有不同程度症状的患者。根据中医辨证为肝郁脾虚型者作为治疗对象,以方剂疏肝健脾解毒方为主要治疗药物。治疗后6个月观察临床症状和病毒标志物的变化,并观察停药后3个月以评估疗效的持久性。共入组患者348例,其中161例纳入对照组,187例纳入治疗组。治疗组采用方剂疏肝健脾解毒方中医治疗。结果治疗组完成治疗168例,总有效率80.3%(135/168),HBeAg转阴6例,HBV DNA下降大于或等于2个对数级14例;停药观察3个月157例,总有效率80.9%(127/157),HBeAg转阴4例,HBV DNA下降大于或等于2个对数级11例,疗效高于对照组(P<0.05)。结论中医疏肝健脾解毒方治疗肝郁脾虚型HBeAg阳性慢性HBV携带者疗效确切,症状改善明显。

Objective To investigate the clinical effect of traditional Chinese medicine（TCM）for treating HBeAg positive chron-ic hepatitis B virus（HBV）carriers with liver stagnation and spleen deficiency syndrome.Methods The patients with HBeAg and HBV DNA positive,normal serum ALT and AST for successive 3 times within 1-year follow up,complicating different degrees of symptoms were included.Among them,the patients with liver stagnation and spleen deficiency syndrome according to the TCM dif-ferentiation were selected as the treatment obj ects and treated by the prescription of soothing the liver,tonifying spleen and detoxifi-cation.The changes of clinical symptoms and HBV markers after 6-month therapy were observed and followed up for 3 months for evaluating the effect persistance.348 cases were recruited,161 cases in the control group and the other 187 cases in the treatment group.Treatment group underwent traditional Chinese medicine treatment.Results 168 cases finished the therapy with the total effective rate of 80.3%（135/168）,6 cases were HBeAg negative conversion and 14 cases were HBV DNA decrease greater than or equal to 2 logarithmic grades;157 patients finished 3-month follow-up and the effective rate was 80.9%（127/157）,4 cases were HBeAg negative conversion and 1 1 cases were HBV DNA decrease greater than or equal to 2 logarithmic grades.The curative effect of treatment group was higher than that of control group.Conclusion The TCM prescription of soothing the liver,tonifying spleen and detoxification has definite effect for treating HBeAg positive chronic HBV carriers with liver stagnation and spleen deficiency syndrome,the symptoms can be significantly improved.