中西医结合治疗慢性乙型肝炎合并非酒精性脂肪性肝炎的临床观察

Curative effect of combination of traditional Chinese and Western Medicine on chronic hepatitis B patients with nonalcoholic fatty liver disease

目的:观察中西医结合治疗慢性乙型肝炎合并非酒精性脂肪性肝炎的临床效果,并探讨其对血清核转录因子(NF-κB)肿瘤坏死因子(TNF-α)的影响。方法:选取2014年7月-2015年10月我院收治的68例慢性乙型肝炎合并非酒精性脂肪性肝炎患者,按照随机分配原则将其分为两组,每组34例,对照组患者单纯使用西药,研究组患者在对照组的基础上加用中药,治疗12个月后比较两组患者的治疗效果,对比分析两组患者治疗前后血清NF-κB、TNF-α等指标变化。结果:治疗12个月时,研究组患者血清HBV DNA、AST、ALT、NF-κB、TNF-α水平及中医证候积分均明显低于对照组(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:中西医结合治疗慢性乙型肝炎合并非酒精性脂肪性肝炎疗效显著,可以降低患者血清NF-κB、INF-α水平,有效改善患者肝功能,且不良反应少,安全可靠,值得临床推广应用。

Objective： To study the clinical effect of integrated traditional Chinese and Western medicine in the treatment of chronic hepatitis B （CHB） and nonalcoholic fatty liver disease, and to explore the effect on serum NF-KB and TNF-α. Methods ：Sixty eighty cases of chronic hepati- tis B patients with nonalcoholic fatty liver disease were divided into control group and study group（54 cases in each group）from July 2014 to October 2015 in our hospital according to the principle of random assignment, the control group were treated with western medicine treatment, the study group was based on the control group with traditional Chinese medicine treatment, compared two groups of patients, and the comparison of serum NF-KB, TNF-α index changes before and after treatment in two groups. Results： the treatment of third, 6 and 12 months after the study, total biliru- bin, AST, ALT recovery, HBV DNA negative cases were significantly better than the control group （P 〈 0.05）. Before treatment, two groups of pa- tients with serum HBV DNA, AST, ALT, NF-KB level and TCM syndrome scores of TNF-a had no significant difference （P 〉0. 05） ; after 12 months of treatment, patients in the study group, serum HBV DNA, AST, ALT, NF-KB level and TCM syndrome scores of TNF-α were significantly lower than the control group （P 〈 0.05）. There was no significant difference in the incidence of adverse reactions between the two groups （P 〉 0. 05）. Conclusion： the combination of traditional Chinese and Western medicine therapy in the treatment of chronic hepatitis B complicated with non- alcoholic steatohepatitis has obvious curative effect, can reduce serum NF-KB, TNF-α level, improve liver function, and less adverse reaction, safe and reliable, worthy of clinical application.