舒肝解毒汤治疗慢性乙型肝炎的临床观察

Clinical Observation of Shugan Jiedu Decoction for Treatment of Chronic Hepatitis B

【目的】观察以舒肝解毒汤为主方辨证加减治疗慢性乙型肝炎的临床疗效。【方法】将120例慢性乙型肝炎患者随机分为治疗组80例和对照组40例。治疗组给予自拟的舒肝解毒汤为基础方辨证加减治疗,对照组给予常规护肝治疗(护肝片及复方甘草酸苷片口服),2组均以3个月为1个疗程。治疗期间,观察2组患者的临床证候、不良反应、理化检查[总胆红素(TBIL)、直接胆红素(DBIL)、丙氨酸氨基转移酶(ALT)等]以及乙型肝炎病毒(HBV)标记物(包括HBV-DNA定量)的变化情况。【结果】(1)经1个疗程治疗后,治疗组的症状疗效及肝功疗效总有效率分别为96.25%和88.75%,显著优于对照组的92.50%和82.50%(P<0.05)。(2)治疗后,2组除脾肿大证候积分改善无统计学意义(P>0.05)外,其余各项证候积分均较治疗前显著改善(P<0.01)。(3)治疗后,2组血清TBIL、DBIL、ALT水平均较治疗前显著改善,差异均有统计学意义(P<0.01)。(4)治疗后,治疗组乙型肝炎表面抗原(Hbs Ag)、乙型肝炎e抗原(Hbe Ag)、HBV-DNA的阴转率分别为26.25%、38.98%、61.25%,优于对照组的22.50%、37.93%、42.50%,差异均有统计学意义(P<0.05)。【结论】以舒肝解毒汤为基础方辨证加减治疗慢性乙型肝炎疗效确切,安全可靠,无明显不良反应和毒副作用。

Objective To observe the therapeutic effect of syndrome-differentiation treatment mainly with Shugan Jiedu Decoction for chronic hepatitis B（CHB）. Methods A total of 120 CHB patients were randomized into treatment group（80 cases） and control group（40 cases）. The treatment group was given syndrome-differentiation treatment mainly with self-prescribed Shugan Jiedu Decoction, and the control group was given conventional therapy for preventing the liver, mainly treated with oral use of Hugan Tablets and Compound Glycyrrhizin Tablets. The treatment for the two groups lasted for 3 months. The clinical outcomes included clinical symptoms and signs,adverse reaction,hepatitis B virus（HBV）marker（HBV-DNA quantitative assay）and physiochemical parameters of total bilirubin（TBIL）,direct bilirubin（DBIL）and alanine transferase（ALT）.Results（1）After treatment for 3 months, total effective rate for relieving symptoms and total effective rate for improving hepatic function of the treatment group were 96.25%,88.75%,and those of the control group were92.50%, 82.50% respectively, the difference between the two groups being significnat（P〈0.05）.（2）After treatment, the difference of the improvement of splenomegaly scores in both groups was insignificant compared with that before treatment（P〉0.05）, but the scores of other signs were much improved in both groups after treatment compared with those before treatment（P〈0.01）.（3）Serum levels of TBIL, DBIL and ALT of both groups were much improved compared with those before treatment（P〈0.01）.（4）The rates for hepatitis B surface antigen（Hbs Ag）, hepatitis B e antigen（Hbe Ag）and HBV-DNA turning negative were26.25%,38.98%,61.25% in the treatment group,respectively,being superior to 22.50%,37.93%,42.50%in the control group,the difference being significant（P〈0.05）. Conclusion Syndrome-differentiation treatment mainly with Shugan Jiedu Decoction is effective and safe for the treatment of chronic hepatitis B.