疏肝醒脾通络汤联合恩替卡韦治疗肝郁脾虚型慢性乙型肝炎肝硬化的临床观察

Clinical observation on treating the liver stagnation and spleen deficiency type of chronic hepatitis B cirrhosis with the Shugan Xingpi Tongluo decoction plus entecavir

目的:观察疏肝醒脾通络汤联合恩替卡韦治疗肝郁脾虚型慢性乙型病毒性肝炎(简称乙型肝炎)肝硬化的效果。方法:随机选取2018年1月-2019年10月治疗的肝郁脾虚型慢性乙型肝炎肝硬化患者共80例,以入院治疗单双号顺序为根据将入选者分为试验组与对照组,每组例数40例。试验组患者治疗方案为恩替卡韦联合疏肝醒脾通络汤,对照组则单纯使用恩替卡韦,分别观察两组患者肝功能指标、T淋巴细胞亚群水平、临床治疗效果、中医证候积分、不良反应。结果:试验组治疗后肝功能指标丙氨酸氨基转移酶(Alanine Aminotransferase,ALT)、天门冬氨酸氨基转移酶(Aspartate Aminotransferase,AST)、总胆红素(Total Bilirubin,TBIL)及临床治疗效果、中医证候积分均优于对照组(P<0.05);与治疗前相比,两组治疗后T淋巴细胞亚群CD3+、CD4+、CD8+均不同程度上升,但仅对照组CD4+以及试验组CD3+、CD4+、CD8+与治疗前的差异有统计学意义(P<0.05),组内CD4+/CD8+值及两组间治疗后各项指标的差异均无统计学意义(P>0.05)。结论:恩替卡韦联合疏肝醒脾通络汤方案用于治疗慢性乙型肝炎肝硬化(肝郁脾虚型),临床效果及患者的肝功能改善均明显提高。

Objective:To observe the effect of the Shugan Xingpi Tongluo decoction(疏肝醒脾通络汤)plus entecavir on the liver stagnation and spleen deficiency type of chronic hepatitis B cirrhosis.Methods:A total of 80 cases who were treated from January 2018 to October 2019 were random selected and divided into the test group and the control group according to the order of the odd and even numbers of admission to the hospital,and 40 cases in each group.The test group was treated with the Shugan Xingpi Tongluo decoction plus entecavir,and the control group only took entecavir.Results:After treatment,the levels of ALT,AST,TBIL,clinical effects and TCM syndrome scores in the test group were better than those in the control group(P<0.05).Compared with before treatment,the levels of CD3+,CD4+and CD8+in the two groups were increased in different degrees after treatment,but only CD4+level in the control group,and the levels of CD3+,CD4+and CD8+in the test group were significantly different from those before treatment,while there was no statistically significant difference in CD4+/CD8+values between before and after treatment within each group and in the indexes between the two groups after treatment(P>0.05).Conclusion:The Shugan Xingpi Tongluo decoction plus entecavir can improve the therapeutic effect and liver function of patients with the liver stagnation and spleen deficiency type of chronic hepatitis B cirrhosis significantly.