柴胡疏肝散联合富马酸替诺福韦二吡呋酯治疗肝郁气滞型慢性乙型肝炎的疗效研究

文章信息/Info

• Title:Chaihu Shugan Powder Combined with Tenofovir Fumarate in Treating Chronic Hepatitis B with Liver Depression and Qi Stagnation

• 卷期:2021年19卷24期

• 作者:张金付

• 福建中医药大学附属三明市中西医结合医院肝病科,  福建三明365001

• Author(s):Zhang Jinfu

• Sanming Hospital of Integrated Traditional Chinese and Western Medicine affiliated to Fujian University of Traditional Chinese Medicine, Sanming 365001, China

• 关键词:柴胡疏肝散；富马酸替诺福韦二吡呋酯；肝郁气滞；慢性乙型肝炎

• Keywords:physiology; experiment teaching; curriculum ideological and political education; morality - oriented education

• 摘要:目的：观察柴胡疏肝散联合富马酸替诺福韦二吡呋酯对肝郁气滞型慢性乙型肝炎的疗效。方法：60例肝郁气滞型慢性乙型肝炎患者随机平均分为2组，对照组予以富马酸替诺福韦二吡呋酯及保肝、降酶治疗，治疗组在对照组的基础上予以柴胡疏肝散治疗。治疗3个月后观察两组患者中医证候评分、总有效率、肝功能、血清病毒载量、肝脏硬度等情况。结果：治疗后治疗组中医证候评分、肝功能指标、血清病毒载量、肝脏硬度均低于对照组（P＜0.05），治疗组总有效率高于对照组（P＜0.05）。两组HBV-DNA转阴率比较差异无统计学意义(P＞0.05)。 结论：柴胡疏肝散联合富马酸替诺福韦二吡呋酯在改善肝郁气滞型CHB患者中医证候、肝功能，降低肝脏硬度等方面优于单用富马酸替诺福韦二吡呋酯治疗。                                                                                                                                

• Abstract:Objective:To observe the effect of Chaihu Shugan Powder combined with tenofovir fumarate on chronic hepatitis B with liver depression and qi stagnation.Methods:60 cases of chronic hepatitis B patients with liver depression and qi stagnation type were randomly divided into 2 groups. The control group was treated with tenofovir fumarate and hepatoprotective and enzyme-lowering treatment. The treatment group was treated with Chaihu Shugan Powder on the basis of the control group. After 3 months of treatment, observe the two groups of patients TCM syndrome score, total effective rate, liver function, serum viral load, liver stiffness, etc.Results:After treatment, the TCM syndrome score, liver function index, serum viral load, and liver stiffness of the treatment group were lower than those of the control group (P<0.05), and the total effective rate of the treatment group was higher than that of the control group (P<0.05).The negative conversion rate of the DNA of hepatitis b virus(HBV-DNA)were observed in two groups．Conclusion:Chaihu Shugan Powder combined with tenofovir fumarate is better than single-use tenofoate fumarate in improving TCM syndromes, liver function, reducing liver stiffness in patients with liver depression and stagnation type CHB.                                                                                                                                                                                                                

  慢性乙型肝炎（Chronic hepatitis B，CHB）是指感染了乙型肝炎病毒（Hepatitis B virus，HBV）且乙型肝炎表面抗原阳性或者HBV-DNA阳性超过6个月的肝脏慢性炎症性疾病。长期CHB患者可能发生肝代偿失调，未经抗病毒治疗CHB患者每年大概有2-10%会发生肝硬化，肝硬化患者每年大概有3-6%进展为肝癌。全球约有2.7亿人长期感染HBV，而我国HBV感染者大概有7000万，严重危害世界人民和我国国民健康。美国肝病研究协会2009年发布的CHB治疗指南中新增了一线抗病毒药物富马酸替诺福韦二吡呋酯，富马酸替诺福韦二吡呋酯可快速、有效抑制HBVDNA复制，促进CHB患者病毒表面抗原定量持续下降。柴胡疏肝散有疏肝理气、活血止痛的功用，常用于肝郁气滞型CHB的治疗。本研究通过对CHB患者予以柴胡疏肝散联合富马酸替诺福韦二吡呋酯治疗，探讨了柴胡疏肝散联合富马酸替诺福韦二吡呋酯对CHB患者中医证候评分、总有效率、血清病毒载量、肝脏硬度等的影响，为临床寻求更优的CHB治疗方案提供思路。