广州中医药大学学报2026，Vol.43Issue(5)：1176-1182,7.DOI:10.13359/j.cnki.gzxbtcm.2026.05.007
疏肝健脾化瘀方治疗肝郁脾虚夹瘀型慢性乙型肝炎的临床研究
Clinical Study on the Shugan Jianpi Huayu Formula in the Treatment of Chronic Hepatitis B with Liver Depression and Spleen Deficiency Complicated by Blood Stasis Syndrome
摘要
Abstract
Objective To observe the clinical efficacy of the Shugan Jianpi Huayu Formula(modified from Xiaoyao San plus Gezha Zhuyu Decoction)in the treatment of patients with chronic hepatitis B(CHB)presenting with liver depression and spleen deficiency complicated by blood stasis syndrome.Methods A retrospective cohort study was conducted.A total of 100 CHB patients with liver depression and spleen deficiency complicated by blood stasis syndrome and abnormal alanine aminotransferase(ALT)levels,who visited the Hepatology Department outpatient clinic of Bao'an Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine(Shenzhen Bao'an Traditional Chinese Medicine Hospital Group)from September 2023 to March 2025,were divided into an exposure group and a control group based on the treatment with the Shugan Jianpi Huayu Formula,with 50 cases in each group.The control group received conventional liver-protection and antiviral therapy,while the exposure group received the Shugan Jianpi Huayu Formula in addition to the conventional therapy.The treatment course for both groups was 24 weeks.Changes in TCM syndrome scores,liver stiffness measurement(LSM)values,liver function indicators[alanine aminotransferase(ALT),aspartate aminotransferase(AST),gamma-glutamyl transferase(GGT)],serum hepatitis B surface antigen(HBsAg),and hepatitis B virus deoxyribonucleic acid(HBV-DNA)levels were observed before and after treatment in both groups,and the clinical efficacy and medication safety were evaluated.Results(1)Regarding efficacy,after 24 weeks of treatment,the total effective rate was 98.00%(49/50)in the exposure group and 82.00%(41/50)in the control group.Intergroup comparison(by chi-square test)showed that the clinical efficacy of the exposure group was significantly superior to that of the control group(P＜0.05).(2)Regarding liver function,after treatment,the levels of liver function indicators ALT,AST,and GGT were significantly decreased in both groups compared to before treatment(P＜0.05),and the decreases were significantly greater in the exposure group than in the control group(P＜0.05).(3)Regarding LSM,after treatment,LSM values showed a decreasing trend in both groups compared to before treatment,but the differences were not statistically significant(P＞0.05);however,intergroup comparison revealed that the reduction in LSM values was significantly greater in the exposure group than in the control group(P＜0.05).(4)Regarding TCM syndrome scores,after treatment,the scores were significantly decreased in both groups compared to before treatment(P＜0.05),and the decrease was significantly greater in the exposure group than in the control group(P＜0.05).(5)Regarding serum HBsAg and HBV-DNA levels,there were no significant differences between the exposure group and the control group in improving these parameters(P＞0.05).However,patients receiving initially antiviral treatment showed significantly greater improvements in serum HBsAg and HBV-DNA levels compared to those who had previously received regular antiviral treatment(P＜0.05).(6)Regarding safety,during the treatment process,no significant adverse reactions occurred in either group,indicating a favorable safety profile.Conclusion The Shugan Jianpi Huayu Formula demonstrates definitive efficacy in treating CHB patients with liver depression and spleen deficiency complicated by blood stasis syndrome and abnormal liver function.It can significantly improve patients'liver function and clinical symptoms,and also shows some effect in reducing LSM values,with its therapeutic effect being significantly superior to conventional western medicine treatment alone.关键词
疏肝健脾化瘀方/逍遥散/膈下逐瘀汤/慢性乙型肝炎/肝郁脾虚夹瘀型/肝功能/回顾性队列研究Key words
Shugan Jianpi Huayu Formula/Xiaoyao San/Gexia Zhuyu Decoction/chronic hepatitis B(CHB)/liver depression and spleen deficiency complicated by blood stasis syndrome/liver function/retrospective cohort study分类
医药卫生引用本文复制引用
孙姮辉,朱琴艳,欧阳子琛,鲁艳平,胡敬宝,钟丽云,陈欣怡..疏肝健脾化瘀方治疗肝郁脾虚夹瘀型慢性乙型肝炎的临床研究[J].广州中医药大学学报,2026,43(5):1176-1182,7.基金项目
国家中医药管理局综合司·国家卫生健康委办公厅·中央军委后勤保障部卫生局:强化建设的重大疑难疾病中西医临床协作项目(编号:ZDYN-2024-B-012) （编号:ZDYN-2024-B-012）
深圳市"医疗卫生三名工程"资助项目(编号:SZZYSM202311014) （编号:SZZYSM202311014）
