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目的观察柴芍疏肝健脾汤联合恩替卡韦分散片治疗慢性乙型病毒性肝炎(以下简称慢性乙肝)的临床疗效及对患者肝功能指标的影响。方法将60例慢性乙肝患者随机分为3组。西药组20例,予恩替卡韦分散片治疗;中药组20例,予柴芍疏肝健脾汤治疗;联合组20例,予柴芍疏肝健脾汤联合恩替卡韦分散片治疗。3组均治疗6个月后观察疗效及乙型肝炎病毒脱氧核糖核酸(HBV-DNA)转阴率,并比较3组治疗前后肝功能指标谷氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBi L)及白蛋白(Alb)水平变化。结果联合组总有效率95.0%,西药组总有效率70.0%,中药组总有效率80.0%,联合组疗效优于西药组及中药组(P<0.05),西药组与中药组疗效相当(P>0.05);3组治疗后肝功能指标ALT、AST、TBi L及Alb水平与本组治疗前比较差异均有统计学意义(P<0.05),ALT、AST、TBi L水平下降,Alb水平升高,且联合组治疗后ALT及AST水平改善明显优于西药组及中药组(P<0.05),西药组与中药组治疗后肝功能指标ALT、AST、TBi L及Alb水平相当(P>0.05);联合组治疗后HBV-DNA阴转率90.0%,西药组转阴率65.0%,中药组转阴率15.0%,联合组治疗后HBV-DNA阴转率高于西药组及中药组(P<0.05),西药组治疗后HBV-DNA阴转率高于中药组(P<0.05)。结论柴芍疏肝健脾汤联合恩替卡韦分散片治疗慢性乙型病毒性肝炎可明显提高临床疗效,改善肝功能,减低ALT、AST及TBi L水平,升高Alb水平,降低HBV毒量,促进HBV-DNA转阴。
Objective To observe the clinical efficacy of Chai Sha Shugan Jianpi Decoction combined with entecavir dispersible tablets in the treatment of chronic hepatitis B (hereinafter referred to as chronic hepatitis B) and its effect on liver function indexes. Methods Sixty patients with chronic hepatitis B were randomly divided into three groups. 20 cases in the western medicine group were treated with entecavir dispersible tablets; 20 cases in the traditional Chinese medicine group were treated with Chaishao Shugan Jianpi Decoction; 20 cases in the combined group were treated with Chaishao Shugan Jianpi Decoction combined with entecavir dispersible tablets. After 6 months of treatment, the curative effect and HBV-DNA negative rate of hepatitis B virus were observed in all three groups. The changes of liver function indexes such as ALT, Aminotransferase (AST), total bilirubin (TBi L) and albumin (Alb) levels. Results The total effective rate was 95.0% in the combined group, 70.0% in the western medicine group and 80.0% in the traditional Chinese medicine group. The combined group had better curative effect than western medicine group and traditional Chinese medicine group (P <0.05) > 0.05). The levels of ALT, AST, TBiL and Alb in the three groups after treatment were significantly different from those before treatment (P <0.05), the levels of ALT, AST, TBiL and Alb (P <0.05). The ALT, AST, TBiL and Alb levels of western medicine group and traditional Chinese medicine group after treatment were significantly higher than those of western medicine group and traditional Chinese medicine group (P <0.05) ). The negative conversion rate of HBV-DNA in the combination group was 90.0%, the negative conversion rate in the western medicine group was 65.0%, and the negative conversion rate in the traditional Chinese medicine group was 15.0%. The negative conversion rate of HBV-DNA in the combination group was higher than that in the western medicine group and the traditional Chinese medicine group <0.05). The negative conversion rate of HBV-DNA in the western medicine group was higher than that in the traditional Chinese medicine group (P <0.05). Conclusion Chishao Shuganjianpi Decoction combined with entecavir dispersible tablets in the treatment of chronic viral hepatitis B can improve the clinical curative effect, improve the liver function, decrease the levels of ALT, AST and TBiL, increase the level of Alb, reduce the level of HBV and promote the expression of HBV DNA negative.