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目的评价加味小柴胡汤联合阿德福韦酯治疗慢性乙型肝炎(chronic hepatitis B,CHB)的效果。方法选择2008年1月—2012年10月收治的CHB患者180例,随机分为对照组与试验组各90例,对照组早晨空腹口服阿德福韦酯片10 mg,1次/d,200 ml温开水送服。试验组在对照组基础上加服加味小柴胡汤,水煎服,日1剂。两组均治疗48周,在治疗期间不得使用其他抗病毒、免疫调节、护肝降酶等药物。治疗48周后检测两组HA、PCⅢ、LN、ALT。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果治疗后对照组HA、PCⅢ、LN、ALT[(212.4±42.3)、(135.2±11.6)、(146.2±35.6)ng/ml、(60.5±14.8)U/L]与试验组[(165.3±36.6)、(89.2±10.5)、(118.3±28.6)ng/ml、(35.5±13.6)U/L]比较差异均有统计学意义(均P<0.05)。两组HBeAg和HBV-DNA转阴率对照组分别为64.4%、55.5%,试验组分别为90.0%、85.6%,比较差异均有统计学意义(均P<0.05)。结论加味小柴胡汤联合阿德福韦酯治疗CHB能显著降低肝血清生化指标、纤维化指标和HBV-DNA水平,值得临床推广应用。
Objective To evaluate the effect of Modified Xiaochaihu Decoction combined with adefovir dipivoxil in the treatment of chronic hepatitis B (CHB). Methods One hundred and eighty CHB patients admitted from January 2008 to October 2012 were randomly divided into control group and trial group (n = 90). The control group was orally administered with adefovir dipivoxil 10 mg once daily in anabdominal fasting ml warm water delivery service. The experimental group in the control group plus serving flavored Xiao Chai Hu Tang Shuijianbi Day 1. Both groups were treated for 48 weeks, during the treatment may not use other antiviral, immunomodulatory, liver and other drugs down the enzyme. After 48 weeks of treatment, two groups of HA, PCⅢ, LN and ALT were detected. Measurement data using t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results After treatment, the levels of HA, PCⅢ, LN, ALT in the control group were significantly higher than those in the test group [(165 ± 3) vs (135 ± 11.6), (146.2 ± 35.6) 36.6), (89.2 ± 10.5), (118.3 ± 28.6) ng / ml, (35.5 ± 13.6) U / L] (all P <0.05). The negative rates of HBeAg and HBV-DNA in the two groups were 64.4% and 55.5%, respectively, which were respectively 90.0% and 85.6% in the experimental group (all P <0.05). Conclusion Modified Xiao Chai Hu Tang combined with adefovir dipivoxil treatment of CHB can significantly reduce liver biochemical markers of serum fibrosis and HBV-DNA levels, worthy of clinical application.