摘要
目的:探讨柴胡疏肝散加减联合抗病毒药对慢性乙型肝炎(CHB)患者预后的影响。方法:选取2018年8月至2021年8月石家庄市妇幼保健院收治的CHB患者80例,按照随机数字表法分为西药组与联合组,各40例。西药组患者给予常规抗病毒治疗,联合组患者采用柴胡疏肝散加减联合抗病毒治疗。比较两组患者治疗前及治疗12、24和48周的中医证候积分,并在疗程结束后观察治疗应答率。分别在治疗前及治疗12、24和48周检测两组患者乙肝病毒脱氧核糖核酸(HBV-DNA)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、总胆红素(TBIL)和谷氨酰转肽酶(GGT)水平,同时检测两组患者血清白细胞介素(IL)1β、IL-4和肿瘤坏死因子α(TNF-α)水平。记录患者的不良反应发生率,比较两组患者肝纤维化、肝硬化、肝癌及死亡发生情况。结果:两组患者治疗12、24和48周的中医证候评分低于治疗前,且联合组患者明显低于西药组,差异均有统计学意义(P<0.05)。联合组患者的治疗总应答率为92.50%(37/40),高于西药组的75.00%(30/40),差异有统计学意义(P<0.05)。两组患者治疗12、24和48周的HBV-DNA、AST、ALT、TBIL、GGT、IL-1β、IL-4和TNF-α水平低于治疗前(P<0.05);且联合组患者治疗12、24和48周的HBV-DNA、AST、ALT、IL-1β和TNF-α水平低于西药组,治疗24、48周的TBIL、GGT水平低于西药组,治疗48周的IL-4水平低于西药组(P<0.05),差异均有统计学意义。联合组患者的不良反应发生率为15.00%(6/40),与西药组(10.00%,4/40)比较,差异无统计学意义(P>0.05)。联合组患者疾病进展事件发生率为2.50%(1/40),低于西药组的20.00%(8/40),差异有统计学意义(P<0.05)。结论:柴胡疏肝散加减联合抗病毒治疗能促进CHB患者症状的改善,提高治疗应答率,其可能通过改善肝功能与抑制IL-1β、IL-4和TNF-α水平达到治疗目的,能控制疾病进展事件发生风险,用药安全。
OBJECTIVE:To probe into the effects of modified Chaihu Shugan powder combined with antiviral drugs on prognosis of patients with chronic hepatitis B(CHB).METHODS:A total of 80 patients with CHB admitted into Shijiazhuang Maternity&Child Healthcare Hospital from Aug.2018 to Aug.2021 were extracted to be divided into the western medicine group and combination group via the random number table method,with 40 cases in each group.The western medicine group was given conventional antiviral therapy,while the combination group received modified Chaihu Shugan powder combined with antiviral therapy.The traditional Chinese medicine(TCM)syndrome scores of two groups before treatment and at 12,24,and 48 weeks of treatment were compared,and the treatment response rate was observed after the course of treatment.Levels of hepatitis B virus deoxyribonucleic acid(HBV-DNA),aspartate aminotransferase(AST),alanine aminotransferase(ALT),total bilirubin(TBIL),and glutamyl transpeptide(GGT)were detected before treatment and at 12,24,and 48 weeks after treatment.At the same time,levels of serum interleukin(IL)-1β,IL-4 and tumor necrosis factor-α(TNF-α)were detected in two groups.Incidence of adverse drug reactions was recorded,and the incidence of liver fibrosis,liver cirrhosis,liver cancer and death were compared between two groups.RESULTS:The TCM syndrome scores in two groups at 12,24,and 48 weeks after treatment were lower than those before treatment,and the combination group was lower than the western medicine group,with statistically significant difference(P<0.05).The overall response rate of the combination group was 92.50%(37/40),higher than 75.00%(30/40)of the western medicine group,with statistically significant difference(P<0.05).The levels of HBV-DNA,AST,ALT,TBIL,GGT,IL-1β,IL-4 and TNF-αin two groups after treatment for 12,24,and 48 weeks were lower than those before treatment(P<0.05);the levels of HBV-DNA,AST,ALT,IL-1βand TNF-αin the combination group were lower than those in the western medicine group,the levels of TB
作者
张翠丽
李静
霍瑞静
李姣
ZHANG Cuili;LI Jing;HUO Ruijing;LI Jiao(Dept.of Emergency,Shijiazhuang Maternity&Child Healthcare Hospital,Shijiazhuang 050000,China;Dept.of Manufacturing Laboratory,Shijiazhuang Traditional Chinese Medicine Hospital,Shijiazhuang 050000,China;Dept.of Gastroenterology,Xingtai Peolpe’s Hospital,Hebei Xingtai 054000,China;Dept.of Internal Medicine,Shijiazhuang Maternity&Child Healthcare Hospital,Shijiazhuang 050000,China)
出处
《中国医院用药评价与分析》
2023年第2期203-207,共5页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
河北省中医药管理局科研计划项目(No.2020288)。
关键词
柴胡疏肝散
加减治疗
抗病毒治疗
慢性乙型肝炎
肝功能
预后
Chaihu Shugan powder
Modified and subtracted therapy
Antiviral therapy
Chronic hepatitis B
Liver function
Prognosis
