柴胡桂枝干姜汤合当归芍药散联合西药治疗慢性乙型肝炎临床研究
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R512.6+2

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Clinical Study on Chaihu Guizhi Ganjiang Tang and Danggui Shaoyao Powder Combined with Western Medicine for Chronic Hepatitis B
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    摘要:

    目的:观察柴胡桂枝干姜汤合当归芍药散联合西药治疗慢性乙型肝炎(CHB) 的临床疗效。方法:将160例肝郁气滞兼中焦湿阻型CHB患者按随机数字表法分为观察组和对照组各80例。2组均口服恩替卡韦分散片、五酯片治疗,观察组加予柴胡桂枝干姜汤合当归芍药散加减治疗。2组均连续治疗4个月,并进行3个月的随访。于治疗结束时和随访达3个月时检测血清乙型肝炎病毒e 抗原(HBeAg),统计血清学应答和生化学应答情况。治疗前后检测谷丙转氨酶(ALT)、谷草转氨酶(AST)和血清总胆红素(TBil) 等肝功能指标,并评定肝郁气滞证评分,比较2组的疗效。结果:治疗后,观察组的中医证候疗效优于对照组(P<0.05)。2组中医证候评分均较治疗前下降(P<0.01)。观察组中医证候评分低于对照组(P<0.01)。在治疗结束时和随访结束时,观察组的血清HBeAg转阴率、ALT恢复正常率均高于对照组(P<0.05,P<0.01)。2组血清ALT、AST和TBil水平均较治疗前下降(P<0.01)。观察组血清ALT、AST和TBil水平均低于对照组(P<0.01)。结论:应用柴胡桂枝干姜汤合当归芍药散加减联合恩替卡韦分散片、五酯片治疗肝郁气滞兼中焦湿阻型CHB 患者,可促使HBeAg 转阴,保护肝功能,减轻症状,提高中医证候疗效,且疗效稳定、持久。

    Abstract:

    Abstract: Objective: To observe the clinical effect of Chaihu Guizhi Ganjiang tang and Danggui Shaoyao powder combined with western medicine for chronic hepatitis B(CHB). Methods:A total of 160 cases of patients with CHB of liver depression and qi stagnation as well as dampness obstruction in the middle energizer type were divided into the observation group and the control group according to the random number table method, 80 cases in each group. Both groups were treated with oral administration of entecavir dispersible tablets and Wuzhi tablets,and the observation group was additionally treated with Chaihu Guizhi Ganjiang tang and Danggui Shaoyao powder. Both groups were treated for four months and following-up for three months. After treatment and after three months of following-up respetively,hepatitis B virus e antigen (HBeAg) in serum was detected,and the responses of serology and biochemistry were counted. Before and after treatment, the indexes of the liver function such as alanine aminotransferase(ALT), aspartate aminotransferase(AST) and total bilirubin (TBil) in serum were detected;the scores of liver depression and qi stagnation syndrome were evaluated. The clinical effect in the two groups was compared. Results: After treatment, the curative effect of Chinese medicine syndrome in the observation group was better than that in the control group(P<0.05). The Chinese medicine syndrome scores in the two groups were decreased when compared with those before treatment(P<0.01),and the score in the observation group was lower than that in the control group(P<0.01). After treatment and after following-up respectively,the negative rate of HBeAg and the recovery rate of ALT in serum in the observation group were higher than those in the control group(P<0.05,P<0.01). The levels of ALT,AST and TBil in serum in the two groups were decreased when compared with those before treatment(P< 0.01), and the above three levels in serum in the observation group were lower than those in the control group(P<0.01). Conclusion: The therapy of modified Chaihu Guizhi Ganjiang tang and Danggui Shaoyao powder combined with entecavir dispersible tablets and Wuzhi tablets in treating CHB patients of liver depression and qi stagnation as well as dampness obstruction in the middle energizer type can improve the negative rate of HBeAg and the curative effect of Chinese medicine syndrome,protect the liver function,and reduce symptoms,with stable and lasting curative effect.

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许菊香,陈小桂,徐胜.柴胡桂枝干姜汤合当归芍药散联合西药治疗慢性乙型肝炎临床研究[J].新中医,2020,52(8):30-33

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  • 在线发布日期: 2020-04-25
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