摘要
目的探讨桃红化浊汤联合恩替卡韦治疗慢性乙型肝炎(chronic hepatitis B,CHB)肝硬化(湿热蕴结证)的临床疗效及安全性。方法前瞻性收集2016年6月至2019年9月西安市中医医院收治的120例CHB肝硬化患者为研究对象,采用随机数字表法将患者分为观察组(60例)和对照组(60例)。对照组采用恩替卡韦治疗,观察组采用桃红化浊汤联合恩替卡韦治疗,比较两组患者治疗前和治疗6个月后单项症状积分、肝功能[包括丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)和总胆红素(total bilirubin,TBil)]、肝纤维化指标[包括透明质酸(hyaluronic acid,HA)、Ⅲ型前胶原氨基末端肽(procollagen typeⅢ,PCⅢ)、层粘连蛋白(laminin,LN)、Ⅳ型胶原(Ⅳcollagen,Ⅳ-C)、肝脏硬度值(liver stiffness measurement,LSM)和FIB-4指数]及HBV DNA载量。比较两组患者的治疗总有效率和不良反应发生率。结果治疗后,两组患者的症状积分均显著低于治疗前,包括双目或皮肤发黄[观察组:(2.22±0.41)分vs(5.22±2.36)分;对照组:(3.41±1.24)分vs(5.17±2.37)分]、恶心呕吐[观察组:(3.47±0.99)分vs(5.63±2.00)分;对照组:(4.48±1.47)分vs(6.30±2.04)分]、食欲不振[观察组:(2.63±0.76)分vs(6.80±1.54)分;对照组:(3.85±1.15)分vs(6.90±1.54)分]、脘腹撑急[观察组:(2.25±0.60)分vs(4.87±1.92)分;对照组:(3.60±1.01)分vs(4.98±1.40)分]及腹胀[观察组:(2.18±0.83)分vs(5.30±1.06)分;对照组:(3.45±1.06)分vs(5.17±1.56)分],且观察组上述症状积分均显著低于对照组,差异均有统计学意义(P均<0.001)。治疗后,两组患者肝功能指标水平均显著低于治疗前,包括血清ALT[观察组:(23.44±4.03)U/L vs(59.07±8.82)U/L;对照组:(39.42±5.09)U/L vs(56.92±7.77)U/L]、AST[观察组:(22.07±4.23)U/L vs(46.18±6.53)U/L;对照组:(35.97±4.03)U/L vs(47.58±7.52)U/L]和TBil[观察组:(9.20±2.27)μmol/L vs(23.98±3.91)μmol/L;对照组:(14.32±4.11)
Objective To investigate the clinical efficacy and safety of Taohong Huazhuo Decoction combined with entecavir on chronic hepatitis B(CHB)cirrhosis(damp-heat accumulation syndrome).Methods A total of 120 patients with CHB cirrhosis who were admitted to Xi’an Hospital of Traditional Chinese Medicine from June 2016 to September 2019 were collected prospectively as the research subjects.The patients were divided into observation group(60 cases)and control group(60 cases)according to random number table method.Patients in control group were treated with entecavir,while patients in observation group were treated with Taohong Huazhuo Decoction combined with entecavir.The scores of single symptoms,liver function indexes[including alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBil)],liver fibrosis indexes[including hyaluronic acid(HA),procollagen typeⅢ(PCⅢ),laminin(LN),Ⅳcollagen(Ⅳ-C),liver stiffness measurement(LSM)and FIB-4 index]and HBV DNA load of patients in both groups before treatment and 6 months after treatment were compared.The total response rate and incidence of adverse reactions were also compared.Results After treatment,the scores of single symptoms of patients in both groups were significantly lower than those before treatment,including binocular or skin yellowing[observation group:(2.22±0.41)points vs(5.22±2.36)points;control group:(3.41±1.24)points vs(5.17±2.37)points],nausea and vomiting[observation group:(3.47±0.99)points vs(5.63±2.00)points;control group:(4.48±1.47)points vs(6.30±2.04)points],inappetence[observation group:(2.63±0.76)points vs(6.80±1.54)points;control group:(3.85±1.15)points vs(6.90±1.54)points],stomach distension[observation group:(2.25±0.60)points vs(4.87±1.92)points;control group:(3.60±1.01)points vs(4.98±1.4)points]and abdominal distension[observation group:(2.18±0.83)points vs(5.30±1.06)points;control group:(3.45±1.06)points vs(5.17±1.56)points],and the above symptom scores of patients in observation group were signif
作者
陈香妮
李淑芳
袁超
Chen Xiangni;Li Shufang;Yuan Chao(Department of Hepatology,Xi’an Hospital of Traditional Chinese Medicine,Xi’an 710021,China)
出处
《中国肝脏病杂志（电子版）》
CAS
2021年第3期9-15,共7页
Chinese Journal of Liver Diseases：Electronic Version
基金
国家级名中医工作室:杨震全国名中医传承工作室国中医药办人教涵【2018】119号。
关键词
桃红化浊汤
肝炎
乙型
慢性
肝硬化
湿热蕴结证
临床疗效
安全性
Taohong Huazhuo Decoction
Hepatitis B,chronic
Cirrhosis
Damp-heat accumulation syndrome
Clinical efficacy
Safety
