摘要
目的:探讨清肝健脾颗粒对干扰素治疗湿热蕴脾证慢性乙型病毒性肝炎(CHB)患者疗效及WBC、PLT的影响。方法:选择2017年6月至2020年6月在我院脾胃病科接受治疗的82例湿热蕴脾证CHB患者。根据随机数字表法分成观察组及对照组,每组各41例。观察组给予清肝健脾颗粒及PEG IFNα-2b干扰素及恩替卡韦片治疗,对照组给予PEG IFNα-2b干扰素及恩替卡韦片治疗,疗程共24周,治疗前后检查血常规、肝功能、血清HBV-DNA定量、HbeAg、抗HBe,对比两组临床症状改善有效率以及两组治疗前后的白细胞计数(WBC)、血小板计数(PLT)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)以及HBV-DNA不可检测率、HbeAg转换率、HBeAg阴转率。结果:使用清肝健脾颗粒的治疗组对患者中医临床症状改善优于对照组(P<0.05),差异有统计学意义。两组患者治疗后肝功能(AST、ALT)均明显低于治疗前(P<0.05),差异有统计学意义。治疗组HBV-DNA不可检测率、HbeAg转换率、HBeAg阴转率分别为56.1%、63.4%、46.3%,优于对照组22.0%、41.5%、23.4%(P<0.05),差异均具有统计学意义。两组患者治疗后较治疗前WBC、PLT均有不同程度降低(P<0.05),停药后4周较停药前有所回升,对照组影响更甚,停药后回升幅度更小(P<0.05)差异有统计学意义。治疗组不良反应率低(23.4%)优于对照组(58.5%)。结论:清肝健脾颗粒对干扰素联合恩替卡韦治疗湿热蕴脾证慢性乙型病毒性肝炎患者疗效较为理想,可有效加强抗病毒疗效及调节免疫,可有效改善干扰素带来的WBC、PLT减少影响,临床疗效好,可推广运用。
Objective:To explore the effect of Qinggan Jianpi granule on the efficacy and WBC、PLT of interferon in the treatment of chronic viral hepatitis B(CHB)with damp-heat spleen accumulation syndrome.Methods:From June 2017 to June 2020,82 patients with dampness and heat accumulation CHB spleen syndrome were selected.According to the method of random number table,41 cases were divided into observation group and control group.Observation group with Qinggan Jianpi Granule and PEG IFNα-2 b Interferon and Entecavir tablets,control group was treated with PEG IFNa-2 b interferon and entecavir tablets.Blood routine and liver function were reviewed before and 24 weeks after withdrawal.Blood routine,liver function,serum HBV-DNA HBeAg and anti-HBe were examined before and after treatment.The effective rate of improvement of clinical symptoms,WBC,PLT,AST,ALT,undetectable rate of HBV-DNA,HBeAg conversion rate and HBeAg negative conversion rate before and after treatment were compared between the two groups.Results:Treatment group with Qinggan Jianpi Granule was better than control group in improving TCM clinical symptoms(P<0.05),The difference was statistically significant.Liver function(AST、ALT)was significantly lower in both groups than before(P<0.05),the difference was statistically significant.The HBV-DNA undetectable rate,HbeAg conversion rate and HBeAg negative conversion rate were 56.1%,63.4%,46.3%,respectively,better than the control group 22.0%,41.5%,23.4%(P<0.05),the difference was statistically significant.After treatment,the WBC、PLT of the two groups were lower than before,(P<0.05).After drug withdrawal,there was a slight increase compared with before drug withdrawal(P<0.05),and the difference was statistically significant.The influence of control group was more significant,and the increase was smaller after drug withdrawal(P<0.05).The adverse reaction rate of Observation group was lower(23.4%)than that of control group(58.5%).Conclusion:Qinggan Jianpi granule has ideal curative effect on interferon combined with
作者
郭红
刘蔚
林煜榆
GUO Hong;LIU Wei;LIN Yu-yu(Guangdong province NO.2 TCM hospital;Guangzhou Traditional Chinese Medicine University)
出处
《按摩与康复医学》
2021年第24期33-36,共4页
Chinese Manipulation and Rehabilitation Medicine
基金
广东省科技厅(项目编号20170215)。
