耳穴磁疗联合中药泡足治疗慢性乙型病毒性肝炎的中医证候疗效及对患者肝功能、生活质量的影响

Therapeutic effect of auricular point magnetic therapy combined with traditional Chinese medicine foot bath on chronic hepatitis B and its effect on traditional Chinese medicine syndromes,liver function and life quality

目的观察耳穴磁疗联合中药泡足治疗慢性乙型病毒性肝炎(CHB)的中医证候疗效及对患者肝功能、生活质量的影响。方法将144例CHB患者随机分为4组,恩替卡韦片组36例予恩替卡韦片治疗,耳穴磁疗+恩替卡韦片组36例予耳穴磁疗+恩替卡韦片治疗,中药泡足+恩替卡韦片组36例予中药泡足+恩替卡韦片治疗,耳穴磁疗+中药泡足+恩替卡韦片组36例予耳穴磁疗+中药泡足+恩替卡韦片治疗。4组均治疗24周。比较4组中医证候疗效;比较4组治疗前后中医证候评分变化,肝功能丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)水平变化,慢性肝脏疾病量表(CLDQ)评分变化。结果耳穴磁疗+中药泡足+恩替卡韦片组总有效率(97.22%,35/36)高于恩替卡韦片组(55.56%,20/36)、耳穴磁疗+恩替卡韦片组(77.78%,28/36)、中药泡足+恩替卡韦片组(75.00%,27/36)(P<0.05);耳穴磁疗+恩替卡韦片组、中药泡足+恩替卡韦片组总有效率高于恩替卡韦片组(P<0.05)。4组治疗后倦怠乏力、胁肋疼痛、脘腹胀闷、食欲不振、恶心呕吐、烦躁易怒、口干口苦评分均低于本组治疗前(P<0.05);耳穴磁疗+恩替卡韦片组治疗后胁肋疼痛、口干口苦评分低于恩替卡韦片组(P<0.05);中药泡足+恩替卡韦片组胁肋疼痛、脘腹胀闷、食欲不振、口干口苦评分低于恩替卡韦片组(P<0.05);耳穴磁疗+中药泡足+恩替卡韦片组胁肋疼痛、脘腹胀闷、食欲不振、恶心呕吐、口干口苦评分低于恩替卡韦片组(P<0.05),胁肋疼痛、脘腹胀闷、恶心呕吐评分低于耳穴磁疗+恩替卡韦片(P<0.05),口干口苦评分低于中药泡足+恩替卡韦片组(P<0.05)。4组治疗后ALT、AST水平均较本组治疗前降低(P<0.05);耳穴磁疗+恩替卡韦片组、中药泡足+恩替卡韦片组、耳穴磁疗+中药泡足+恩替卡韦片组治疗后ALT、AST水平均低于恩替卡韦片组(P<0.05)。耳穴磁疗+恩替卡韦片组治疗后腹部症状、乏力、系统症状评分较本组治疗前升高(P<0.05);中药泡足+恩替卡韦片组、耳穴磁疗+中药泡足+恩替卡韦片组治疗后腹部症状、乏力、系统症状、焦虑评分均较本组治疗前升高(P<0.05);耳穴磁疗+中药泡足+恩替卡韦片组治疗后腹部症状评分均高于其他3组(P<0.05),系统症状、焦虑评分高于恩替卡韦片组(P<0.05),焦虑评分高于耳穴磁疗+恩替卡韦片组(P<0.05)。结论耳穴磁疗联合中药泡足治疗CHB,能更有效地改善患者中医证候和肝功能,提高生活质量。

Objective To observe the therapeutic effect of auricular point magnetic therapy combined with TCM foot bath on chronic hepatitis B(CHB)and its effect on TCM syndromes,liver function and life quality.Methods A total of 144 patients with CHB were randomly divided into 4 groups,36 in each group,Group 1(ear point magnetic therapy+entecavir tablets),Group 2(TCM foot bath+entecavir tablets),Group 3(ear point magnetic therapy+TCM foot bath+entecavir tablets),Group 4(entecavir tablets);24 weeks of treatment in four groups.It aimed to compare the efficacy of TCM syndromes,TCM syndrome scores changes,liver function alanine aminotransferase(ALT),aspartate aminotransferase(AST)levels,as well as chronic liver disease questionnaire(CLDQ)score changes in 4 groups before and after treatment.Results The total effective rate in Group 3(35.0%)was higher than that in Group 1(28.0%),Group 2(27.0%)and Group 4(20.0%),(P<0.05).Group 1 was not statistically different compared with Group 2(P>0.05).After treatment,the scores of fatigue,flank pain,abdominal distension,loss appetite,nausea and vomiting,irritability,dry mouth and bitter mouth in the four groups were all lower than those in this group before treatment(P<0.05);the scores of flank pain and dry mouth and bitter mouth in Group 1 were lower than those in Group 4(P<0.05);the scores of flank pain,abdominal distension,loss appetite,dry mouth and bitter mouth in Group 2 were lower than those in Group 4(P<0.05).The scores of flank pain,abdominal distension,loss appetite,nausea and vomiting,dry mouth and bitter mouth in Group 3 were lower than those in Group 4(P<0.05);the scores of flank pain,abdominal distension,nausea and vomiting in Group 3 were lower than those in Group 1(P<0.05);the scores of dry mouth and bitter mouth in Group 3 were lower than those in Group 2(P<0.05).The levels of ALT and AST after treatment in the four groups were lower than those before treatment in this group(P<0.05);the levels of ALT and AST after treatment in Group 1,Group 2,and Group 3 were lower than those in Group 4(P<0.05);there was no statistically significant difference in ALT and AST levels after treatment in Group 1,Group 2,and Group 3(P>0.05).The scores of abdominal symptoms,fatigue,and system symptoms in Group 1 after treatment were higher than those in this group before treatment(P<0.05);the scores of abdominal symptoms,fatigue,system symptoms,and anxiety in Group 2 and Group 3 after treatment were all higher than those before treatment in this group(P<0.05);the abdominal symptoms scores in Group 3 after treatment were higher than those in other groups(P<0.05);the system symptoms scores in Group 4 after treatment were lower than those in Group 3(P<0.05);the anxiety scores in Group 3 after treatment were higher than those in Group 1 and Group 4(P<0.05);system symptoms scores in Group 1,Group 2 and Group 3 were not statistically different(P>0.05).There was no statistical significance in anxiety score difference in Group 2 and Group 3 after treatment(P>0.05);there was no significant difference in fatigue,activity ability,and emotional scores in all groups after treatment(P>0.05).Conclusion Auricular magnetic therapy combined with TCM foot bath to treat CHB can more effectively improve the TCM syndromes and liver function of patients,and improve the life quality.