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目的:观察分阶段辨证联合针灸疗法、心理干预的综合治疗方法治疗慢性乙型肝炎肝纤维化的临床疗效。方法:医院收治的慢性乙型肝炎肝纤维化患者120例纳入本项研究,使用随机方法按照1∶1分为综合治疗组和对照组,每组各60例。两组均给予恩替卡韦片抗病毒治疗,治疗6个月。对照组给予复方鳖甲软肝片,综合治疗组在口服恩替卡韦治疗基础上用分阶段辨证施治联合针灸疗法、心理干预治疗。观察两组治疗前后中医征候积分、肝功能指标、肝纤维化四项及B型超声指标(门静脉内径、脾脏厚度)。结果:综合治疗组患者治疗的总有效率为86.7%,明显高于对照组的65%,差异具有统计学意义(P<0.05)。与对照组相比,综合治疗组治疗后中医征候积分、肝功能指标、肝纤维化指标及B型超声指标改善更明显,差异均有统计学意义(P<0.05)。结论:分阶段辨证联合针灸疗法、心理干预的综合治疗方法应用于慢性乙型肝炎肝纤维化有助于延缓肝纤维化进程,改善肝功能。
OBJECTIVE: To observe the clinical efficacy of phased syndrome differentiation combined with acupuncture and moxibustion and psychological intervention in the treatment of chronic hepatitis B with liver fibrosis. Methods: A total of 120 chronic hepatitis B patients with liver fibrosis admitted to our hospital were enrolled in this study. The patients were divided into comprehensive treatment group and control group with a ratio of 1: 1 by randomization, with 60 cases in each group. Both groups were given entecavir tablets antiviral therapy for 6 months. The control group was given Fufang Biejia Ruangan Tablet, and the combined treatment group was treated with oral administration of entecavir on the basis of staged syndrome differentiation combined with acupuncture therapy and psychological intervention. TCM symptom scores, liver function indexes, liver fibrosis and B-mode ultrasound indexes (diameter of portal vein and spleen thickness) before and after treatment were observed. Results: The total effective rate of the treatment group was 86.7%, significantly higher than 65% of the control group, the difference was statistically significant (P <0.05). Compared with the control group, TCM syndrome score, liver function index, liver fibrosis index and B-mode ultrasound index improved more obviously in the comprehensive treatment group after treatment, with significant difference (P <0.05). Conclusion: The combination therapy of acupuncture and moxibustion in stages and the intervention of psychological intervention in liver fibrosis of chronic hepatitis B can delay the process of liver fibrosis and improve the liver function.