茵陈白术汤联合阿德福韦酯治疗慢性乙型肝炎的临床观察

目的观察养正、解毒、活血的茵陈白术汤联合阿德福韦酯治疗湿热内蕴型慢性病毒性乙型肝炎的临床效果,探究中西医联合治疗此病的临床价值。方法选取四川省绵阳市中医医院2010年5月～2011年12月门诊和住院部湿热内蕴型慢性乙型病毒性肝炎患者42例,随机分为治疗组（n=22）与对照组（n=20）,治疗组给予中药茵陈白术汤和阿德福韦酯片,对照组仅给予阿德福韦酯口服,疗程均为8周,8周后观察两组患者治疗前后的症状、体征、肝功能及HBV-DNA指标,并做出评价。结果两组临床综合疗效比较差异有统计学意义（P〈0.05）;两组中医症状积分比较,治疗后两组症状均有改善（P〈0.01或P〈0.05）,而治疗组疗效明显效优于对照组（P〈0.05）;治疗后两组肝功能均有不同程度改善（P〈0.05）,而治疗组优于对照组（P〈0.05）;两组HBV-DNA指标比较,治疗组优于对照组（P〈0.05）。结论茵陈白术汤联合阿德福韦酯治疗湿热内蕴型慢性乙型肝炎,在抑制HBV病毒复制、减轻肝脏炎症及改善临床症状方面效果显著,有益于延缓病情发展,且无明显副作用,是治疗慢性乙型肝炎的有效方法之一。

Clinical observation of Capillary Artemisia and Atractylodes Rhizome Decoction combined with Adefovir in the treatment of chronic hepatitis B

Objective To observe the clinical curative effect of Capillary Artemisia and Atractylodes Rhizome Decoction that can support positive qi, detoxify and invigorate the circulation of blood combined with Adefovir in the treatment of type of retention of damp-heat in the interior of chronic viral hepatitis B, and to explore the clinical value of combined therapy of traditional Chinese and western medicine. Methods 42 cases of patients with type of retention of damp-heat in the interior of chronic viral hepatitis B admitted to outpatient and inpatient department of Mianyang Hospital of TCM in Sichuan Province from May 2010 to December 2011 were chosen and randomly divided into treatment group （n = 22） and control group （n = 20）, treatment group was given traditional Chinese medicine Capillary Artemisia and Atractylodes Rhizome Decoction and Adefovir slices. Control group was only given oral Adefovir, the course was eight weeks, after treatment for eight weeks, the symptoms, signs, liver function and HBV-DNA indicators before and after treatment of the two groups were observed and made evaluation. Results Comprehensive clinical effi- cacy of the two groups was significandy different （P 〈 0.05）; symptom scores of the two groups were compared, which showed that, after treatment, symptoms of both groups were improved （P 〈 0.01 or P 〈 0.05）, while effect of treatment group was significantly better than the control group （P 〈 0.05）; after treatment, liver function was improved in both groups more or less （P 〈 0.05）, while the treatment group was better than the control group （P 〈 0.05）; the HBV DNA index of treatment group was better than the control group （P 〈 0.05）. Conclusion Capillary Artemisia and Atractylodes Rhizome Decoction combined with Adefovir in the treatment of type of retention of damp-heat in the interior of chronic viral hepatitis B has remarkable effects in the inhibition of HBV replication, reducing liver inflammation and improving clinical symptoms, which is beneficial to slow the disease and has no obvious side effects, it is one of the effective ways for the treatment of chronic hepatitis B.