肝郁脾虚型慢性乙型肝炎中医证候改善与临床疗效的相关性

The correlation between the improvement of TCM syndrome and clinical efficacy in Chronic Hepatitis B with Syndrome of Liver Stagnation and Spleen Deficiency

目的:探讨肝郁脾虚型慢性乙型肝炎中医证候改善与临床疗效的相关性。方法:纳入符合诊断标准的60例肝郁脾虚型慢性乙型肝炎患者,随机分为治疗组(n=30)和对照组(n=30)。在基础治疗和情志调护的基础上,治疗组加用逍遥散加减治疗。两组患者均治疗3个月。以中医证候积分、情志量表积分、临床疗效、为评价指标,探讨其相关性。结果:①治疗组患者中医证候积分由治疗前(6.70±2.02)下降至(3.17±1.34)(P<0.01),对照组患者中医证候积分由治疗前(6.37±1.50)下降至(3.77±1.22)(P<0.01)。治疗后两组患者中医证候积分改善存在差异,治疗组优于对照组(P<0.05)。②治疗组患者中医证候积分改善与年龄、治疗前HAMA评分、SAS减分、体重变化因子减分、治疗后HBV DNA阴转、治疗前HBeAg(-)均具有相关性(P<0.05),其中与治疗后HBV DNA阴转、SAS减分呈正相关,与体重因子评分、治疗前HAMA呈负相关。结论:①逍遥散可显著改善慢性乙型肝炎患者的中医证候积分。②中医证候疗效改善与SAS减分呈正相关,与治疗前HAMA评分呈负相关,表明慢性乙型肝炎患者的情绪状态在证候疗效中占有主要作用。

objective： To clarify the correlation between the improvement of TCM syndrome and clinical efficacy in Chronic Hepatitis B with Syndrome of Liver Stagnation and Spleen Deficiency. Methods：Sixty patients of Chronic Hepatitis B patients with Syndromeof Liver Stagna- tion and Spleen Deficiency were randomly divided into control group （n =30） and treatment group （n =30）. On the basis of foundation treat- ment and modern regulating, the treatment group were given the Xiaoyao Powder treatment, while the control group however only for founda- tion treatment and modern regulating. All patients were treated for 3 months, TCM syndrome integral, modern scale integral and clinical effica- cy as the effect, to clarify the correlation. Results：（1）TCM syndrome integral in treatment group decreased from 6.70 ±2.02 to 3.17 ± 1.34 （P 〈0.01 ） ,while the control group decreased from 6.37 ± 1. 50 to 3.77 ± 1. 22（P 〈0.01 ）. After the treatment, the TCM syndrome integral in both groups improved differences,and the treatment group was better than that of control group（P 〈0.05）. （2）TCM syndrome integral im- provement was related to age, HAMAscore before treatment, SAS score improvement, weight factor score, HBV DNA turn intonagtive and HBeAg negative before treatment（ P 〈 0.05 ）, which was positively correlated to SAS score improvement and HBV DNA turn into nagtive. However, negatively correlated to the weight factor score,and HAMA score before treatment. Conclusion ：（1）Xiaoyao Powder could improve the TCM syndrome integral of CHB patients. （2）The impact of Xiaoyao Powder which resolve the Liver stagnation and Spleen deficiency has positive relationship with SAS score improvment,and negative relationship with HAMA scroe before treatment,which indicated that the metal state in CHB patinets has a major role in therapeutic effect of syndrome.