温经开郁法治疗慢性乙型肝炎的随机平行对照研究
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佛山市自筹经费类科技计划项目(2017AB000822)


Randomized Parallel Controlled Study of Warming Meridian and Opening Depression Therapy for Chronic Hepatitis B
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    摘要:

    目的:探究温经开郁法对慢性乙型肝炎(CHB)的疗效。方法:选取2016年6月至2019年1月广东省中西医结合医院收治的CHB患者26例作为研究对象,按照就诊顺序编号随机分为对照组和观察组,每组13例。对照组予恩替卡韦治疗,观察组在对照组基础上加用温经开郁颗粒,均同时治疗24周。观察2组患者治疗前、完成治疗后淋巴细胞亚群、谷丙转氨酶(ALT)、谷草转氨酶(AST)、ALT/AST比值、谷氨酰转移酶(GGT)、透明质酸酶(HA)、层黏蛋白(LN)、Ⅲ型前胶原N端肽(PⅢNP)、Ⅳ型胶原(CⅣ)、乙肝病毒脱氧核糖核酸(HBV-DNA)、慢性肝病问卷(CLDQ)评分变化并比较,并进行疗效评价。结果:1)对照组治疗前、完成治疗后CD4+、CD8+、CD4+/CD8+比较,差异无统计学意义(P>0.05),完成治疗后观察组CD4+、CD4+/CD8+较治疗前均显著升高,CD8+较治疗前显著下降(P<0.05),完成治疗后观察组CD4+、CD4+/CD8+显著高于对照组,CD8+显著低于对照组(P<0.05)。2)完成治疗后2组患者ALT、AST、ALT/AST比值、GGT较治疗前均显著下降(P<0.05),且观察组以上指标下降均显著低于对照组(P<0.05)。3)完成治疗后2组患者HA、LN、PⅢNP、CⅣ较治疗前均显著下降(P<0.05),完成治疗后观察组以上指标均显著低于对照组(P<0.05)。4)完成治疗后2组患者腹部症状、困乏、系统症状、活动能力、情感、焦虑积分较治疗前均显著升高(P<0.05),完成治疗后观察组以上积分均显著高于对照组(P<0.05)。5)完成治疗后观察组显效率、总有效率均显著高于对照组比较,差异有统计学意义(P<0.05)。结论:温经开郁法能提高CHB免疫功能,改善肝功能和肝纤维化,提高生命质量。

    Abstract:

    To explore the therapeutic effect of warming meridians and opening depression on chronic hepatitis B(CHB).Methods:A total of 26 CHB patients hospitalized in Guangdong Integrated Traditional Chinese and Western Medicine from June 2016 to January 2019 were randomly divided into a control group(13 cases)and an observation group(13 cases)according to the order of visit.The control group was treated with entecavir,while the observation group was treated with Wenjing Kaiyu Granules on the basis of the control group for 24 weeks.Lymphocyte subsets,alanine aminotransferase(ALT),aspartate aminotransferase(AST),ALT/AST,glutamyltransferase(GGT),hyaluronidase(HA),laminin(LN),procollagen type III N-terminal peptide(P III NP),collagen type IV(C IV)were observed before and after treatment.The changes of chronic liver disease questionnaire(CLDQ)scores were compared and evaluated after treatment.Results:1)There was no significant difference in CD4+,CD8+,CD4+/CD8+ in the control group before and after treatment(P>0.05).After treatment,CD4+,CD4+/CD8+ in the observation group increased significantly,while CD8+ decreased significantly(P<0.05).After treatment,CD4+,CD4+/CD8+ in the observation group was significantly higher than that in the control group,and CD8+ in the observation group was significantly lower than that in the control group(P<0.05).2)After treatment,ALT,AST,ALT/AST,GGT and in the 2 groups were significantly lower than those before treatment(P<0.05),and the above indexes in the 2 groups were significantly lower than those in the control group(P<0.05).3)After treatment,HA,LN,P III NP,C IV and HBV-DNA in the 2 groups decreased significantly compared with those before treatment(P<0.05),and the above indexes in the observation group were significantly lower than those in the control group(P<0.05).4)The scores of abdominal symptoms,sleepiness,systemic symptoms,activity ability,emotion and anxiety in the 2 groups after treatment were significantly increased than those before treatment(P<0.05),and those in the observation group after treatment were significantly higher than those in the control group(P<0.05).After the completion of treatment,the marked efficiency and total efficiency of the observation group were significantly higher than those of the control group,and the difference was statistically significant(P<0.05).Conclusion:Warming meridians and opening depression method can improve CHB immune function,liver function and liver fibrosis,and improve the quality of life.

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吴艺锋,黄腊平,陈声鑫.温经开郁法治疗慢性乙型肝炎的随机平行对照研究[J].世界中医药,2019,(10).

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  • 收稿日期:2019-03-13
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  • 在线发布日期: 2019-11-21
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