加味膈下逐瘀汤联合恩替卡韦片对治疗瘀血阻络型慢性乙肝临床研究

Clinical Research on Chronic Hepatitis B of Blood Stagnation Pattern Treated with Modified Gexia Zhuyu Decoction and Entecavir Tablets

目的探究加味膈下逐瘀汤联合恩替卡韦片对治疗瘀血阻络型慢性乙肝患者的临床治疗效果。方法选取2014年1月-2016年2月我院收治的60例瘀血阻络型慢性乙肝患者。根据随机数字表法分为治疗组和对照组,每组30例,对照组采用0.5 mg恩替卡韦片治疗,治疗组在对照组的基础上用加味膈下逐瘀汤联合治疗,对患者治疗前、治疗后的血清纤维化指标、肝功能指标以及治疗疗效和不良反应情况进行观察。结果两组各项血清肝纤维化指标治疗前无统计学意义(P>0.05)。治疗后层黏蛋白(LN)、透明质酸(HA)、IV型胶原(IVC)、Ⅲ型前胶原(PCⅢ)指标均有所改善,但治疗组明显优于对照组,两组比较差异有统计学意义(P<0.05)。两组各项肝功能指标治疗前差异无统计学意义(P>0.05)。治疗后丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、白蛋白(ALB)、总胆红素(TBIL)指标均有所改善,但治疗组明显优于对照组,两组差异有统计学意义(P<0.05);治疗组、对照组的治疗有效率为96.7%、80.0%,两组比较差异有统计学意义(P<0.05)。治疗组、对照组不良反应发生率分别为6.7%、16.7%,两组比较差异有统计学意义(P<0.05)。结论采用加味膈下逐瘀汤联合恩替卡韦片治疗瘀血阻络型慢性乙肝患者,不仅能够改善患者的血清肝纤维化指标,还可促进患者治疗后的康复,具有较高的安全性,值得临床推广和应用。

Objective To observe the therapeutic effects on chronic hepatitis B of blood stagnation pattern treated with modified gexia zhuyu decoction and entecavir tablets. Methods From January 2014 through to February 2016,60 patients of chronic hepatitis B of blood stagnation pattern were collected. According to the random number table,they were divided into a treatment group and a control group,30 cases in each one. In the control group,entecavir tablets,0. 5 mg were used. In the treatment group,besides the treatment as the control group,the modified gexia zhuyu decoction was used in combination. Before and after treatment,the serum fibrosis indexes,liver function indexes,the therapeutic effects and adverse reactions were observed. Results The fibrosis indexes were not different significant before treatment between the two groups.After treatment,the levels of LN,HA,IVC and PCIII were all improved. The improvements in the treatment group were remarkable as compared with the control group,indicating the significant differences（ P〈0. 05）.The liver function indexes were not different significantly before treatment between the two groups（ P〉0. 05）. After treatment,the levels of ALT,AST,ALB and TBIL were all improved. The improvements in the treatment group were remarkable as compared with the control group,indicating the significant differences（ P〈0. 05）. The total effective rate was 96. 7% in the treatment group and was 80. 0% in the control group,indicating the significant difference（ P〈0. 05）. The incidence of adverse reactions was 6. 7% in the treatment group and was 16. 7% in the control group,indicating the significant difference（ P〈0. 05）. Conclusion The combined medication of the modified gexia zhuyu decoction and entecavir tablets improves in fibrosis indexes and promotes the recovery of the patients with chronic hepatitis B of blood stagnation pattern. This therapy is safe and deserves to be promoted in clinical practice.