补肾祛邪法治疗慢性乙型肝炎的疗效观察及对肠道菌群的影响

Clinical effect of BushenQuxie method in treatment of chronic Hepatitis B and its impact on the intestinal flora

目的:探讨补肾祛邪法治疗慢性乙型肝炎(CHB)患者的临床疗效及对肠道菌群的影响。方法:选取本院2013年9月至2015年2月门诊和住院诊断为CHB的患者60例,随机分为两组,每组30例。对照组患者给予恩替卡韦分散片,治疗组患者在对照组的基础上加用补肾祛邪法。两组疗程均为半年。分别记录两组患者治疗前后中医证候情况,检测血清HBV DNA、ALT、AST,并测定粪便中主要肠道菌群的水平及计算双歧杆菌/肠杆菌(B/E)比值。结果:临床总有效率治疗组为83.3%,对照组为56.6%,两组比较,差异有显著性意义(P<0.05)。血清HBV DNA水平比较,两组患者治疗12周、24周后与治疗前比较,差异均有显著性意义(P<0.05);两组间治疗12周比较,差异无显著性意义(P>0.05),治疗24周后,差异有显著性意义(P<0.05)。两组患者治疗后血清ALT、AST较治疗前均下降明显(P<0.05),两组患者治疗后比较,差异有统计学意义(P<0.05)。对照组患者治疗前后肠道菌群定量、B/E变化不明显,差异无统计学意义(P>0.05),治疗组改变明显,差异有统计学意义(P<0.05);组间比较,两组患者治疗后差异有统计学意义(P<0.05)。结论:补肾祛邪法可以有效改善CHB患者中医证候及肝功能水平,也可以调节其肠道菌群变化。

Objective：To observe the clinical effect of BushenQuxie method in treatment of chronic Hepatitis B and its impact on the intestinal flora. Methods：From September 2013 to February 2015, total of 60 patients were randomly divided into two groups： control group （ treated with Entecavir dispersible tablets ） and treatment group （ treated with Entecavir dispersible tablets and BushenQuxie medicine ）. Each group bad 30 patients and the course of treatment was 6 months. Two groups were recorded TCM syndrome, tested the indicators of HBVDNA, ALT, AST, detected the level of main intestinal flora in human feces and calculated the B/E ratio before and after treatment. Resuits ：The results showed that the total effective rate of treatment group was 83.3% and control group was 56.6%, the difference was significant（ P 〈0.05）. Serum HBV DNA levels of two groups after 12W, 24W treatment were significantly lower than before （P 〈 0. 05 ） ; Compared between the two groups, it was showed no significant difference at 12W treatment （P 〉 0. 05 ） but a significant difference at 24W treatment（ P 〈 0. 05 ）. The ALT and AST was significantly lower than before treatment（ P 〈 0.05 ） ; two groups were compared after treatment, the difference was statistically significant（ P 〈 0.05 ）. There was no significant difference in quantitative of intestinal floraand B/E in the control group before and after treatment （P 〉 0.05 ） ; but the difference of treatment group was statistically significant （P 〈 0.05 ）. Compared between the two groups after treatment, it was showed a significant difference（ P 〈 0.05 ）. Conclusion： Bushenquxie medicine can effectively improve TCM syndrome and liver function, besides, it also effect intestinal flora.