疏肝健脾颗粒对肝郁脾虚型慢性乙型病毒性肝炎的临床治疗作用及对患者生活质量的影响

Clinical Effect of Shugan Jianpi Granule on Chronic Hepatitis B with Liver Stagnation and Spleen Deficiency and Its Influence on Quality of Life of Patients

目的：研究疏肝健脾颗粒治疗肝郁脾虚型慢性乙型病毒性肝炎的临床疗效及对其对基体免疫功能的调节作用和对生活质量的改善情况。方法：70例CHB患者,随机分为两组,对照组患者口服恩替卡韦分散片和复方甘草酸苷片;治疗组在对照组基础上加以疏肝健脾颗粒治疗,两组患者均连续治疗24周。检测比较治疗前后两组的Th1、Th2、Th17及Treg细胞比例和数量;比较血清肝功能指标、肝纤维指标及乙型肝炎病毒标记物情况;对两组患者的中医证候积分及生活质量进行评价;监测两组治疗过程中的不良反应。结果：治疗后治疗组的中医证候积分及生活质量显著高于对照组（P〈0.05）;治疗组Treg/Th17及Th1/Th2在治疗后明显低于对照组（P〈0.05）。治疗阻治疗16、24周后,HBsAg转阴数、HBeAg转阴数、HBeAg转换数、ALT复常数及HBV DNA转阴数明显高于对照组,差异显著（P〈0.05）。经治疗后,治疗组的肝功能指标及肝纤维化指标也显著低于对照组（P〈0.05）。结论：疏肝健脾颗粒不仅可以明显抑制HBV的复制,改善CHB患者肝功能,提高机体免疫功能,值得临床广泛推广。

Objective： To study the clinical efficacy of Shugan Jianpi Granule in the treatment of chronic hepatitis B with liver stagnation and spleen deficiency type,and its effect on the regulation of matrix immune function and the improvement of quality of life. Methods： Seventy cases of CHB patients were randomly divided into 2 groups. The control group was treated with Entecavir Dispersible Tablets and Compound Glycyrrhizin Tablets,and the treatment group was treated with Shugan Jianpi Granules on the basis of the control group. The 2 groups were treated for 24 weeks. The two groups＇ 2 Th1,Th2,Th17 and Treg cell ratio and quantity,serum indexes of liver function,liver fibrosis index and hepatitis B virus markers before and after treatment were compared. We evaluated the quality of life score and TCM syndromes and monitored adverse reactions during the treatment. Results： After treatment,the TCM syndrome score and quality of life in the treatment group were significantly higher than those in the control group（ P〈 0. 05）. The Treg/Th17 and Th1/Th2 in the treatment group were significantly lower than those in the control group after treatment（ P〈 0. 05）.After 16 and 24 weeks treatment,HBs Ag negative number,HBeAg negative number,HBeAg conversion number,ALT complex constant and HBV DNA negative number were significantly higher than those in the control group,and the difference was significant（ P〈 0. 05）. After treatment,the treatment group＇s fibrosis indexes of liver function were significantly lower than those of the control group（ P〈 0. 05）. Conclusion： Shugan Jianpi Granules can not only inhibit HBV replication,improve the liver function of patients with CHB and improve immune function,worthy of clinical application.