疏肝健脾解毒汤联合西药治疗慢性乙型肝炎随机平行对照研究

Shugan Jianpi Jiedu Tang Combined with Western Medicine Treatment of Chronic Hepatitis B Random Parallel Control Study

[目的]观察疏肝健脾解毒汤联合西药治疗慢性乙型肝炎疗效。[方法]使用随机平行对照方法,将92例住院患者按抽签方法随机分为两组,对照组46例肝泰乐0.2g/次,联苯双酯15mg/次,胸腺肽肠溶胶囊15mg/次,均3次/d。治疗组46例疏肝健脾解毒汤,柴胡、女贞子各10g,茯苓、五爪龙各15g,白芍12g,珍珠草30g,白术、白花蛇舌草、虎杖、土茯苓各20g,甘草6g;黄疸,加茵陈9g,郁金9g;肝脾肿大和面色黧黑,加桃仁9g,生牡蛎10g,制鳖甲6g;湿阻中焦和舌苔厚腻,加藿香12g,厚朴9g,法半夏10g;热毒盛,加黄连、栀子各9g,虎杖10g,大黄6g;脾虚泄泻,加太子参9g,砂仁10g;肝肾阴虚,加枸杞子10g,生地9g。水煎服,1剂/d,2次/d,早晚口服。西药治疗同对照组。连续治疗24周为1疗程。观测肝炎效应指标、临床症状、不良反应。连续治疗4个疗程,判定疗效。[结果]治疗组显效21例,有效16例,无效9例,总有效率80.43%。对照组显效14例,有效12例,无效10例,总有效率56.52%。治疗组疗效优于对照组(P<0.05)。治疗组HBeAg阴转率和HBV DNA应答率均显著优于对照组(P<0.05)。[结论]疏肝健脾解毒法联合西药治疗慢性乙型肝炎效确切,可有效改善病情,值得推广。

[Objective]To observe the Shugan Jianpi Jiedu Tang combined with western medicine treatment of chronic hepatitis b.[Methods]Using random parallel control method,92 cases of hospitalized patients were randomly divided into two groups according to the lottery method,the control group of 46 cases of liver of 0.2g / times,biphenyl diester 15mg / times,XiongXianTai enteric capsules 15mg / time,3 times / d.Treatment group(46 cases the Shugan Jianpi Jiedu Tang Chaihu,Nvzhenzi each 10g,Fuling,Wuzhualong each 15g,Baishao 12g,Zhenzhucao 30g,Baishu,Sheshecao,Huzhang,Tufuling each 20g,Gancao 6g;Liver and spleen enlargement and complexion Taoren 9g,Shengmuli 10g,Zhibiejia 6g;Wet resistance medium and thick greasy coating on the tongue,and Huoxiang 12g,Houbu 9g,Fabanxia 10g;Toxic heat,Huanglian,Zhizhi each 9g,Huzhang 10g,Dahuang 6g;Diarrhea,pixu(spleen deficient) and Taizishen 9g,Sharen 10g;Liver and kidney Yin deficiency,add Gouqizi 10g,Shengdi 9g.Water decoction,1 / day,2 times / d,oral sooner or later.Western medicine treatment with the control group.Continuous 24 weeks of treatment for 1 course of treatment.Observed hepatitis effect indexes improve,clinical symptoms and adverse reactions.Four courses of treatment continuously,judge curative effect.[Result]The treatment group 21 cases were markedly effective,effective in 16 cases,9 no effect,the total effective rate was 80.43%.Control group 14 cases had marked effect,12 cases,10 cases were invalid,the total effective rate was 56.52%.Treatment group curative effect is better than that of control group(P < 0.05).Treatment group HBeAg negative transfer rate and the HBV DNA response rates were significantly better than control group(P < 0.05).[Conclusion]Shugan Jianpi Jiedu Tang combined western medicine treatment of chronic hepatitis b effect exactly,can effectively improve the condition,is worth promoting.