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1、加味柴平湯對HBeAg陰性慢性乙型肝炎的臨床研究[摘要]為觀察在“大辨證理論”指導下結合“攻下排毒”和“中藥現(xiàn)代藥理研究”認識組合而成的加味柴平湯治療HBeAg陰性慢性乙型肝炎的臨床效果,選擇119例HBeAg陰性慢性乙型肝炎患者,隨機分為治療組69例,對照組50例。治療組采用加味柴平湯治療(每日1劑分2次口服,每周服用6劑),對照組采用拉米夫定治療(每次100mg,每日1次),共用藥48周。2組患者分別在治療12,24,36,48周進行肝功能、血清HBV-DN八和臨床癥狀的觀察,并對停藥后24和48周的患者進行ALT和血清IIBV-DNA的隨訪。治療組在2
2、4周總有效率與對照組比較無統(tǒng)計學差異,但在12,36,48周總有效率高于對照組(P〈0.05);在12,36,48周改善肝功能方面優(yōu)于對照組(P〈0.01或P〈0.05),但在24周改善ALT方面與對照組比較無統(tǒng)計學差異;在12周改善血清IIBV-DNA方面明顯低于對照組(P<0.01),但在24,36,48周改善血清HBV-DNA方面與對照組比較無統(tǒng)計學差異;在12,24,36周HBV-DNA陰轉率低于對照組(P〈0.01或P〈0.05),但在48周HBV-DNA陰轉率與對照組比較無統(tǒng)計學差異;在12周和24周改善疲乏、納差、腹脹和脅痛優(yōu)于對照組(P〈0.
3、01或P〈0.05),但在36周和48周改善疲乏和脅痛方與對照組比較無統(tǒng)計學差異;患者的ALT在停藥后24和48周異常率明顯低于對照組(P〈0.01),血清I1BV-DNA定量異常率在停藥后24周與對照組比較無統(tǒng)計學差異,但在48周則低于對照組(P〈0.05)。加味柴平湯長期用藥與間歇用藥相結合對HBeAg陰性慢性乙型肝炎具有較好的臨床療效,應進一步在辨病施治與辨證論治相結合指導下優(yōu)化和完善其處方組成,并開展其對肝纖維化和生存質量影響的臨床研究。[關鍵詞]大辨證理論;加味柴平湯;HBeAg陰性慢性乙型肝炎;臨床療效[Abstract]Toobservethe
4、clinicalefficacyofmodifiedChaipingdecoctionforHBeAg-negativechronichepatitisBunderDaBianZhengtheory(syndromedifferentiationtheory)guidancewithunderstandingofpurgativedetoxingandmodernpharmacologyresearchoftraditionalChinesemedicine.ThepatientswithHBeAg-negativechronichepatitisB(n=l
5、19)wererandomlydividedintotreatmentgroup(n二69)andcontrolgroup(n=50).ThepatientsintreatmentgroupweretreatedwiththemodifiedChaipingdecoction(6closesperweek,onedoseeverydayintwotimesbyoraladministration),andthepatientsincontrolgroupweretreatedwithlamivudinc(LAM)(100mg/timc,onceaday).A
6、llofpatientsweretreatedfor48weeks.Theliverfunctions,levelsofDNAofhepatitisBvirus(HBV-DNA)andclinicalsymptomswereobservedatweeks12,24,36and48inbothgroups.ThelevelsofALTandHBV-DNAinserumwerealsoobserved24weeksand48weeksaftertreatmentintwogroups.Therewasnosignificantdifferenceintotale
7、ffectiveratebetweentreatmentgroupandcontrolgroupatweek24,butthetotaleffectiverateintreatmentgroupwashigherthanthatinthecontrolgroupatweeks12,36and48(P[Keywords]DaBianZhengtheory;modifiedChaipingdecoction;IIBeAg-negativechronichepatitisB;clinicalefficacydoi:10.4268/cjcmm20162026慢性乙型
8、病毒性肝炎(chronichepatitisB,CH