摘要
目的探讨苦菜膏联合恩替卡韦治疗肝郁脾虚证慢性乙型肝炎肝纤维化的临床疗效。方法将陕西省榆林市中医医院肝病科门诊2019年1月—2022年12月治疗的60例肝郁脾虚证慢性乙型肝炎肝纤维化患者按照随机数字表法分为2组,每组30例,对照组给予口服恩替卡韦胶囊治疗,每次0.5 mg,每日1次;观察组在对照组用药基础上给予口服中药膏剂苦菜膏治疗,每日2次,每次10 g,疗程均为48周。比较2组治疗前与治疗后血清学肝纤维化指标4项[透明质酸(HA)、IV型胶原(IV-C)、III型前胶原(PC-III)、层连黏连蛋白(LN)]、肝脏功能指标[AST、总胆红素(TBil)、ALT]、肝脏硬度值(LSM)、HBV DNA阴转率、HBeAg阴转率及2组中医症候疗效。结果观察组AST、ALT、TBil、PC-Ⅲ、LN、HA、IV-C水平和LSM值均明显低于对照组(P<0.05),观察组48周HBV DNA的转阴率比对照组高,(P<0.05),与对照组相比观察组HBeAg阴转率没有统计学意义(P>0.05),观察症候积分明显低于对照组(P<0.05),观察组总有效率明显高于对照组(P<0.05)。结论慢性乙型肝炎肝纤维化患者用苦菜膏联合恩替卡韦治疗后的临床症状改善明显,肝脏功能、血清学肝纤维化指标及肝脏硬度值均有所降低,提高了临床疗效。
Objective To explore the clinical effect of Kucai paste combined with Entecavir in the treatment of chronic hepatitis B liver fibrosis with stagnation of liver qi and spleen deficiency syndrome.Methods A total of 60 patients with chronic hepatitis B liver fibrosis with stagnation of liver qi and spleen deficiency syndrome admitted to Yulin Hospital of Traditional Chinese Medicine from January 2019 to December 2022 were divided into the control group and the observation group according to random number table method,with 30 cases in each group.The control group was given Entecavir capsules,and received 0.5mg orally each time,once a day.On the basis of the treatment of the control group,the observation group was given Kucai paste,and received 10g orally each time,twice a day.The treatment period of both groups was 48 weeks.Four serological liver fibrosis indexes[hyaluronic acid(HA),type IV collagen(IV-C),precollagen type III(PC-III),laminin(LN)]levels,liver function indexes(AST,TBil,ALT)levels,liver stiffness measurernents(LSM),negative conversion rate of HBV DNA,negative conversion rate of HBeAg,and the efficacy of traditional Chinese medicine(TCM)syndromes were compared between the observation group and the control group before and after treatment.Results The levels of AST,ALT,TBil,PC-Ⅲ,LN,HA,IV-C,and LSM values in the observation group were significantly lower than those in the control group(P<0.05).The negative conversion rate of HBV DNA in the observation group at 48 weeks was higher than that in the control group(P<0.05).There was no statistically signigicant difference in the negative conversion rate of HBeAg in the observation group compared to the control group(P>0.05).The TCM symptom score in the observation group was significantly lower than that in the control group(P<0.05).The total effective rate in the observation group was significantly higher than that in the control group(P<0.05).Conclusion After treatment with Kucai paste combined with Entecavir,the clinical symptoms and liver function of patients with chronic hepatitis B liver fibrosis are significantly improved,and serological liver fibrosis indexes levels and LSM are all reduced,which improves the clinical efficacy.
作者
李梦琪
刘繁荣
郭新建
朱敏
刘彦花
王欢欢
白玉
常凯旋
LI Mengqi;LIU Fanrong;GUO Xinjian;ZHU Min;LIU Yanhua;WANG Huanhuan;BAI Yu;CHANG Kaixuan(Shaanxi University of Chinese Medicine,Xianyang 712000,China;Yulin Hospital of Traditional Chinese Medicine,Yulin 719000,China)
出处
《长春中医药大学学报》
2024年第3期301-305,共5页
Journal of Changchun University of Chinese Medicine
基金
陕西省中医药管理局科技产业与发展处科研计划(SZY-NLTL-2022-002)。
关键词
苦菜膏
恩替卡韦
慢性乙型肝炎
肝纤维化
肝郁脾虚证
Kucai paste
Entecavir
chronic hepatitis B
hepatic fibrosis
syndrome of stagnation of liver qi and spleen deficiency
