摘要
目的观察黄连温胆汤联合恩替卡韦治疗慢性乙型肝炎肝纤维化的疗效。方法将2018年1月至2019年3月安康市中心医院收治的72例慢性乙型肝炎患者按照随机数表法分为观察组和对照组,每组36例,对照组患者在常规治疗基础上给予恩替卡韦治疗,观察组患者在对照组治疗基础上联合黄连温胆汤治疗,疗程均为6个月。比较两组患者治疗后的临床疗效、治疗前及治疗6个月后的谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBil)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)、层黏连蛋白(LN)、透明质酸酶(HA)水平、肝纤维化Ishak评分及中医证候积分,并记录治疗期间的不良反应发生情况。结果治疗6个月后,观察组患者的临床疗效总有效率为91.67%,明显高于对照组的72.22%,差异有统计学意义(P<0.05);治疗6个月后,观察组患者的ALT、AST、TBil、PCⅢ、Ⅳ-C、LN、HA、肝纤维化Ishak评分分别为(39.54±4.13) U/L、(45.05±3.91) U/L、(23.03±2.51)μmol/L、(117.34±9.30) ng/mL、(114.85±15.01) ng/mL、(89.34±7.45) ng/mL、(106.64±13.03) ng/mL、(1.52±0.20)分,明显低于对照组的(55.05±4.31) U/L、(62.17±4.53) U/L、(29.74±2.09)μmol/L、(149.85±10.01) ng/m L、(137.02±17.36) ng/m L、(110.57±6.82) ng/m L、(134.84±17.21) ng/mL、(1.86±0.33)分,差异均有统计学意义(P<0.05);治疗6个月后,中医证候积分中,观察组患者的口干口臭、胁肋胀痛、皮肤巩膜黄染、小便黄赤和舌苔黄腻积分分别为(1.19±0.21)分、(1.33±0.18)分、(1.25±0.23)分、(1.40±0.17)分、(1.30±0.19)分,明显低于对照组的(1.65±0.34)分、(1.92±0.16)分、(1.84±0.25)分、(1.86±0.12)分、(1.74±0.16)分,差异均有统计学意义(P<0.05);治疗期间观察组和对照组患者不良反应总发生率分别为13.89%和11.11%,差异无统计学意义(P>0.05)。结论黄连温胆汤联合恩替卡韦治疗慢性乙型肝炎肝纤维化可有效改善患者的肝功能、肝纤维化指标及中医�
Objective To objective the effect of Huanglian Wendan Decoction combined with entecavir in the treatment of liver fibrosis in patients of chronic hepatitis B.Methods Seventy-two patients of chronic hepatitis B who received therapy from January 2018 to March 2019 in Ankang Central Hospital were selected,which were divided into an observation group and a the control group by random number table,with 36 patients in each group.The control group was given entecavir tablets on the basis of conventional treatment,and the observation group was treated with Huanglian Wendan Decoction on the basis of the control group.The course of treatment was 6 months.The clinical efficacy at after treatment 6 months,the changes of the alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),procollagenⅢ(PCⅢ),collagenⅣ(Ⅳ-C),laminin(LN),hyaluronidase(HA),liver fibrosis Ishak scores,and TCM syndrome scores were compared between the two groups before and after treatment,and the adverse reactions during treatment were recorded.Results After 6 months of treatment,the total effective rate of the observation group was 91.67%,which was significantly higher than 72.22%of the control group(P<0.05);after treatment,the ALT,AST,TBIL,PCⅢ,Ⅳ-C,LN,HA,and liver fibrosis Ishak scores in the observation group were(39.54±4.13)U/L,(45.05±3.91)U/L,(23.03±2.51)μmol/L,(117.34±9.30)ng/mL,(114.85±15.01)ng/mL,(89.34±7.45)ng/mL,(106.64±13.03)ng/mL,(1.52±0.20)points,which were significantly lower than(55.05±4.31)U/L,(62.17±4.53)U/L,(29.74±2.09)μmol/L,(149.85±10.01)ng/mL,(137.02±17.36)ng/mL,(110.57±6.82)ng/mL,(134.84±17.21)ng/mL,(1.86±0.33)points in the control group(P<0.05).After treatment,for TCM syndrome scores,the scores of dry mouth and halitosis,costal distension pain,skin and sclera yellow staining,urine yellow red,and tongue coating yellow greasy in the observation group were(1.19±0.21)points,(1.33±0.18)points,(1.25±0.23)points,(1.40±0.17)points,(1.30±0.19)points,which were significantly lower than
作者
朱凤
张峰
王玮
李冰
ZHU Feng;ZHANG Feng;WANG Wei;LI Bing(Department of Infectious Diseases,Department of Traditional Chinese Medicine,Ankang Central Hospital,Ankang 725000,Shaanxi,CHINA;Department of Infectious Diseases,Ankang Central Hospital,Ankang 725000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2021年第4期438-441,共4页
Hainan Medical Journal
关键词
慢性乙型肝炎
肝纤维化
恩替卡韦
黄连温胆汤
肝功能
中医证候积分
不良反应
Chronic hepatitis B
Liver fibrosis
Entecavir
Huanglian Wendan Decoction
Liver function
TCM syndrome score
Adverse reactions
