补肾清热法联合恩替卡韦治疗慢性乙型肝炎(alt≤2×uln)肝损伤研究

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1、1提要目的：观察补肾清热法联合恩替卡韦治疗慢性乙型病毒性肝炎（ALT≤2×ULN）的临床疗效。方法：随机选取42例慢性乙型病毒性肝炎患者（ALT≤2×ULN）（其中治疗前后行肝组织穿刺活检者21例），给予灵猫方颗粒，每日1剂；恩替卡韦0.5mg/d，疗程48周。观察治疗前后肝组织病理及相关肝功能指标。结果：治疗48周后，HBeAg阳性与阴性患者均能有效地出现病毒学应答，ALT、AST水平比治疗前显著下降（P<0.01）；两组患者肝组织病理改善不理想，经统计学分析没有差异(P>0.05)。结论：补肾

2、清热法联合恩替卡韦能有效抑制病毒复制、改善肝功能；但因肝实质恢复慢等原因，不能明显改善肝脏病理。1关键词补肾清热法；恩替卡韦；慢性乙型病毒性肝炎；肝脏损伤11课题来源：“艾滋病和病毒性肝炎等重大传染病防治”科技重大专项“十一五”计划课题“慢性乙型肝炎（轻型）中西医结合治疗方案研究”（课题编号2008ZX10005-006）TheResearchofLiverInjuryoftheMethodofBushenqingrewithEntecavirinTreatingChronicHepatitisB

3、（ALT≤2×ULN）Speciality:InternalmedicineofTCM.Author:SunPengFei.Tutor:ProfessorLiYong.AbstractObjective:ToexploretheclinicaleffectofthemethodofBushenqingrewithentecavirintreatingchronichepatitisB（ALT≤2×ULN）.Methods:42casesofchronicviralhepatitispatients

4、（ALT≤2×ULN）(whichbeforeandaftertreatmentofliverbiopsyin21cases)wererandomlychoosed,givingthecivetpartyparticles,1agentdaily;entecavir0.5mg/d,48weekstreatment.Toobservedbeforeandaftertreatmentinhepatictissuepathologyandrelatedindexesofliverfunction.Res

5、ults:aftertreatmentof48weeks,patientswhateverinHBeAg(+)or(-)caneffectivelyappearvirologicresponse,thelevelsofALTandASTweresignificantlydecreasedthanbeforetreatment(P<0.01);twogroupsofpatientswithhistologicalimprovementwerenotideal,statisticalanalysisr

6、evealednodifferences(P>0.05).Conclusion:themethodofBushenqingrewithentecavirplaysignificantlyeffectiveinsuppressingviralreplication,improvingliverfunction;butbecausetheliverparenchymaofslowrecoveryandotherreasons,unabletosignificantlyimproveliverpatho

7、logy.KeywordsmethodofBushenqingre;entecavir;chronichepatitisB;liverinjury目录引言...............................................................................................................................1资料与方法.........................................

8、..................................................................................2一、病例资料.......................................................................................................................2（一）诊断标准...........................