CAJ | 학술논문

目的：观察中医治疗肝郁脾虚型 HBeAg阳性的慢性乙型肝炎病毒（HBV）携带者的临床疗效。方法选择 HBeAg和 HBV DNA阳性，1年内连续随访3次以上均显示血清 ALT和 AST在正常范围，伴有不同程度症状的患者。根据中医辨证为肝郁脾虚型者作为治疗对象，以方剂疏肝健脾解毒方为主要治疗药物。治疗后6个月观察临床症状和病毒标志物的变化，并观察停药后3个月以评估疗效的持久性。共入组患者348例，其中161例纳入对照组，187例纳入治疗组。治疗组采用方剂疏肝健脾解毒方中医治疗。结果治疗组完成治疗168例，总有效率80．3％（135/168），HBeAg转阴6例，HBV DNA下降大于或等于2个对数级14例；停药观察3个月157例，总有效率80．9％（127/157），HBeAg转阴4例，HBV DNA下降大于或等于2个对数级11例，疗效高于对照组（P＜0．05）。结论中医疏肝健脾解毒方治疗肝郁脾虚型 HBeAg阳性慢性 HBV携带者疗效确切，症状改善明显。
목적：관찰중의치료간욱비허형 HBeAg양성적만성을형간염병독（HBV）휴대자적림상료효。방법선택 HBeAg화 HBV DNA양성，1년내련속수방3차이상균현시혈청 ALT화 AST재정상범위，반유불동정도증상적환자。근거중의변증위간욱비허형자작위치료대상，이방제소간건비해독방위주요치료약물。치료후6개월관찰림상증상화병독표지물적변화，병관찰정약후3개월이평고료효적지구성。공입조환자348례，기중161례납입대조조，187례납입치료조。치료조채용방제소간건비해독방중의치료。결과치료조완성치료168례，총유효솔80．3％（135/168），HBeAg전음6례，HBV DNA하강대우혹등우2개대수급14례；정약관찰3개월157례，총유효솔80．9％（127/157），HBeAg전음4례，HBV DNA하강대우혹등우2개대수급11례，료효고우대조조（P＜0．05）。결론중의소간건비해독방치료간욱비허형 HBeAg양성만성 HBV휴대자료효학절，증상개선명현。
Objective To investigate the clinical effect of traditional Chinese medicine(TCM)for treating HBeAg positive chron-ic hepatitis B virus(HBV)carriers with liver stagnation and spleen deficiency syndrome.Methods The patients with HBeAg and HBV DNA positive,normal serum ALT and AST for successive 3 times within 1-year follow up,complicating different degrees of symptoms were included.Among them,the patients with liver stagnation and spleen deficiency syndrome according to the TCM dif-ferentiation were selected as the treatment obj ects and treated by the prescription of soothing the liver,tonifying spleen and detoxifi-cation.The changes of clinical symptoms and HBV markers after 6-month therapy were observed and followed up for 3 months for evaluating the effect persistance.348 cases were recruited,161 cases in the control group and the other 187 cases in the treatment group.Treatment group underwent traditional Chinese medicine treatment.Results 168 cases finished the therapy with the total effective rate of 80.3%(135/168),6 cases were HBeAg negative conversion and 14 cases were HBV DNA decrease greater than or equal to 2 logarithmic grades;157 patients finished 3-month follow-up and the effective rate was 80.9%(127/157),4 cases were HBeAg negative conversion and 1 1 cases were HBV DNA decrease greater than or equal to 2 logarithmic grades.The curative effect of treatment group was higher than that of control group.Conclusion The TCM prescription of soothing the liver,tonifying spleen and detoxification has definite effect for treating HBeAg positive chronic HBV carriers with liver stagnation and spleen deficiency syndrome,the symptoms can be significantly improved.