柴疏四君汤联合阿德福韦酯胶囊治疗肝郁脾虚型慢性乙型肝炎疗效观察

Clinical efficacy of Chaishu Sijun Decoction combined with adefovir capsule on chronic hepatitis B with liver stagnation spleen deficiency type

目的观察柴疏四君汤联合阿德福韦酯胶囊治疗肝郁脾虚型慢性乙型肝炎的临床疗效。方法将116例肝郁脾虚型慢性乙型肝炎患者按照随机数字表法分为2组,对照组58例予阿德福韦酯胶囊口服,治疗组58例在对照组治疗基础上予柴疏四君汤治疗。2组均治疗6个月。比较2组治疗前后血清肿瘤坏死因子α(TNF-α)、总胆红素(TBiL)水平、中医证候评分、乙型肝炎病毒基因(HBV-DNA)定量结果及健康状况调查简表(SF-36)评分,并统计2组HBV-DNA转阴率,记录不良反应的发生情况。结果2组治疗后血清TNF-α、TBiL水平均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后中医证候各项评分及总分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗1、6个月HBV-DNA定量均依次降低(P<0.05),但是同一时间点组间比较差异无统计学意义(P>0.05)。治疗组HBV-DNA转阴率高于对照组(P<0.05)。2组治疗后SF-36各项评分均较本组治疗前升高(P<0.05),且治疗组均高于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论柴疏四君汤联合阿德福韦酯胶囊治疗肝郁脾虚型慢性乙型肝炎可有效降低血清TNF-α、TBiL水平,改善患者临床症状,提高生活质量及HBV-DNA转阴率,效果显著。

Objective To observe the clinical efficacy of Chaishu Sijun Decoction combined with adefovir capsule on chronic hepatitis B(CHB)with liver stagnation spleen deficiency type.Methods Totally 116 CHB patients(liver stagnation spleen deficiency type)were randomly assigned to receive either oral adefovir capsule(n=58)or oral adefovir capsule+Chaishu Sijun Decoction(n=58).Treated for 6 months,the aim was to compare tumor necrosis factor-α(TNF-α),total bilirubin(TBil),traditional Chinese medicine(TCM)syndrome score,quantification of hepatitis B virus(HBV)-DNA,Short-Form 36-Item Health Survey(SF-36),HBV-DNA negative rate,adverse reactions.The curative effect was assessed.Results After treatment,TNF-αand TBiL in groups were decreased(P<0.05),which were decreased in the treatment group relevant to the control group(P<0.05).TCM symptom scores in groups were decreased(P<0.05),which decreased in the treatment group compared with the control group(P<0.05).On months 1 and 6,the quantification of HBV-DNA in the two groups decreased sequentially(P<0.05),but with no statistically significant difference between the groups at the same time point(P>0.05).HBV-DNA negative rate was higher in the treatment group than in the control group(P<0.05).After treatment,SF-36 scores in groups were increased(P<0.05),the treatment group was more common(P<0.05).The difference was not statistically significant in the incidence of adverse reactions between groups(P>0.05).Conclusion For CHB patients(liver stagnation spleen deficiency type),Chaishu Sijun Decoction combined with adefovir capsule has a significant effect,which can effectively reduce the levels of TNF-αand TBiL,improve clinical symptoms,quality of life and HBV-DNA negative rate.