健脾疏肝汤联合恩替卡韦治疗乙型肝炎肝硬化失代偿患者的临床观察

目的:验证健脾疏肝汤辨证加减联合恩替卡韦治疗乙肝肝硬化失代偿患者的临床疗效。方法:将80例乙肝肝硬化失代偿期患者采用随机数字表法分治疗组和对照组各40例。两组均给予恩替卡韦抗病毒治疗,治疗组加用健脾疏肝汤加减,疗程均为48周。治疗12周、24周、48周检测患者的乙肝病毒定量(HBV-DNA)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、谷氨酰转肽酶(GGT)、血清白蛋白(ALB)、总胆红素(TBIL)及Child-Pugh分级评分,并统计患者的代偿期稳定率及肝癌发生率。结果:两组治疗后的HBV-DNA、血清ALT、ALB、TBIL水平及Child-Pugh分级评分水平,较治疗前均有改善(P<0.05);而两组同期的组间比较方面,在治疗12周、治疗24周的HBV-DNA、血清ALT、AST、GGT、ALB、TBIL水平及Child-Pugh分级评分水平治疗组均优于对照组(P<0.05);治疗第48周时两组HBV-DNA水平比较差异无统计学意义(P> 0.05),血清ALT、AST、GGT、ALB、TBIL水平及Child-Pugh分级评分水平比较,治疗组优于对照组(P<0.05)。两组患者在治疗后,代偿期稳定率比较,治疗组优于对照组(P<0.05),而肝癌发生率比较,治疗组高于对照组,但差异无统计学意义(P> 0.05)。结论:健脾疏肝汤辨证加减联合恩替卡韦治疗乙肝肝硬化失代偿期患者,能有效提高药物对HBV病毒复制的抑制能力,有效改善患者的生化功能,提高患者的残存肝功能,提高患者的代偿期稳定率。

Clinical Efficacy of Jianpi Shugan Decoction Combined with Entecavir in the Treatment of Decompensated Cirrhosis Resulting from Chronic Hepatitis B

Objective:To study the clinical efficacy of Jianpi Shugan decoction combined with entecavir in the treatment of decompensated cirrhosis result-ing from chronic hepatitis B. Methods:Eighty patients with decompensated cirrhosis resulting from hepatitis B were randomly divided into treatment group and control group,40 cases in each group. The control group was treated with entecavir,and the treatment group was treated with Jianpi Shugan decoction and entecavir.The treatment course lasted for 48 weeks. At the 12 th week,24 th week,and 48 th week of the treatment,quantitative assay of HBV-DNA was applied,serum alanine transaminase(ALT),aspartate aminotransferase(AST),gama glutamine transaminase(GGT),serum albumin,total bilirubin(TBIL) were examined,Child-Pugh grading scores,and the rate of compensatory phase and the incidence of liver cancer were determined. Results:On the levels of HBV-DNA,ALT,AST,GGT,ALB,TBIL and Child-Pugh grading in both groups,after treatment were better than before treatment(P< 0.05),at the 12 th and 24 th week,the treatment group was better than the control group,at the 24 th week,the treatment group was better than the control group(P< 0.05) except for the level of HBV-DNA. After treatment,on the stability rate of compensatory phase,the treatment group was better than the control group(P< 0.05),while the incidence of liver cancer was higher than that in the control group,but without statistical significance(P> 0.05). Conclusion:Jianpi Shugan decoction combined with entecavir in the treatment of decompensated cirrhosis resulting from chronic hepatitis B can effectively improve the inhibition of HBV replication,improve the patient's biochemical function,improve the residual liver function and improve the stability rate of compensatory phase.