中医辨证联合阿德福韦酯治疗慢性乙型肝炎的临床研究

易婷; 郑婷婷; 刘津含; 严桐

中医辨证联合阿德福韦酯治疗慢性乙型肝炎的临床研究

常州市第三人民医院中西医结合肝病科，江苏常州 213001

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出版历程
- 刊出日期: 2019-03-10

Effects of TCM Syndrome Differentiation Combined with Adefovir Dimethoate on Liver Function， Liver Fibrosis and Inflammatory Reaction in Patients with Chronic Hepatitis B

摘要

摘要: 目的探讨中医辨证联合阿德福韦酯治疗对慢性乙型肝炎患者肝功能、肝纤维化及机体炎症反应的影响。方法从我院2010年12月至2017年12月收治的慢性乙型肝炎患者中筛选出临床特征相似的患者164名，各组 82人，对照组口服阿德福韦酯治疗，治疗组在口服阿德福韦酯的基础上进行中医辨证治疗，疗程3月。比较2组患者肝功能、肝纤维化及机体炎症反应变化。结果中医辨证分型联合阿德福韦酯治疗的患者经过治疗后显效率、有效率及中医证候积分下降幅度明显优于对照组且较治疗前有显著改善（P<0.05~0.01）；肝功能改善明显优于对照组且较治疗前有显著改善（P<0.01），HBV-DNA转阴率明显高于对照组且较治疗前有显著改善（P<0.05）；治疗组肝纤维化指标透明质酸酶（HA）、Ⅳ型胶原(Ⅳ-C)、层粘连蛋白(LN)均明显低于对照组且较治疗前有显著改善（P<0.01）；机体炎症反应因子包括转化生长因子-β1(TGF-β1)、超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)含量较对照组均明显降低且较治疗前有显著改善（P<0.01）。结论中医辨证联合阿德福韦酯治疗慢性乙型肝炎较单纯西药治疗慢性乙型肝炎能够显著改善其肝功能、肝纤维化及机体炎症反应。
- 慢性乙型肝炎 /
- 肝功能 /
- 辨证 /
- 肝纤维化 /
- 机体炎症反应
Abstract: OBJECTIVE To investigate the effects of TCM syndrome differentiation combined with adefovir dimethoate on liver function， liver fibrosis and inflammatory reaction in patients with chronic hepatitis B (CHB). METHODS 164 patients with chronic hepatitis B in our hospital from December 2010 to December 2017 were divided into two groups， 82 patients in each group. The control group were treated with adefovir dimethoate orally， while the treatment group were treated with TCM syndrome differentiation on the basis of oral adefovir dipivoxil， the course of treatment for 3 months. The changes of liver function， liver fibrosis and inflammatory reaction of two groups were compared. RESULTS The obvious efficiency， effective rate and reduction of TCM syndrome score after treatment of the treatment group were significantly improved compared with those before treatment (P<0.05，P<0.01). The improvement of liver function in treatment group was significantly better than that of the control group and significantly improved than that before treatment(P<0.01). HBV-DNA negative conversion rate was significantly higher than that of the control group and significantly improved than that before treatment (P<0.05). Hyaluronic acid (HA)， type Ⅳ collagen (Ⅳ-C) and laminin (LN) were significantly lower in the treatment group than in the control group and significantly improved than that before treatment (P<0.01). The content of transforming growth factor(TGF-β1)， the hypersensitive C-reactive protein (hs-CRP)， tumor necrosis factor-α (TNF-α) were significantly decreased than that of the control group， and are obviously improved before the treatment. There was statistical significance(P<0.01). CONCLUSION The combination of the syndrome differentiation and adefovir dipivoxil in the treatment of chronic hepatitis B can significantly improve the liver function， liver fibrosis and inflammation of the body.
- chronic hepatitis B /
- liver function /
- differentiation of symptoms and signs /
- liver fibrosis /
- inflammatory reaction

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