摘要目的 探讨小柴胡汤加减治疗慢乙肝合并胆囊炎的临床效果.方法 选取2016年1月至2019年1月期间本院收治的慢乙肝合并胆囊炎患者40例作为研究对象,按随机数字法随机分为两组,各20例.常规组患者给予常规保肝治疗,包括免疫调节剂、抗病毒药物等对症治疗;研究组患者在常规组的基础上增加小柴胡汤加减治疗.观察两组患者治疗后的临床效果,同时检测两组患者治疗前后炎症因子(TNF-α、IL-6、IL-8、IL-10、INF-γ)水平,并比较两组之间的差异.结果 研究组治疗有效率85.00％,明显高于常规组55.00％,差异有统计学意义(P＜0.05);治疗前,两组患者TNF-α、IL-6、IL-8、IL-10、INF-γ水平比较,差异均无统计学意义(均P＞0.05);治疗后,研究组TNF-α、IL-6、IL-8水平分别为(31.22±6.72) ng/L、(30.34±7.49) ng/L、(0.24±0.11) μg/L,明显低于常规组,差异均有统计学意义(均P＜ 0.05);治疗后,研究组IL-10、INF-γ水平分别为(43.41±7.93) μg/L、(33.24±6.11)μg/L,明显高于常规组,差异均有统计学意义(均P＜0.05);研究组不良反应发生率5.00％与常规组10.00％比较,差异无统计学差异(P＞0.05).结论 小柴胡汤加减治疗慢乙肝合并胆囊炎,通过改善患者血清炎症因子发挥治疗作用,可提高治疗效果,且不良反应少.在临床管理中,值得推荐应用.

abstractsObjective To explore the clinical effect of Xiaochaihu decoction for chronic hepatitis B complicated with cholecystitis.Methods Forty patients with chronic hepatitis B complicated with cholecystitis admitted to our hospital from January,2016 to January,2019 were selected as study objects.They were randomly divided into a study group (n=20) and a routine group (n=20) according to random number method.The routine group was given routine liver protection treatment,including immunomodulator,antiviral drugs,and other symptomatic treatment;in addition,the study group were treated wtih Xiaochaihu decoction.The clinical effects of the two groups were observed in detail;the levels of inflammatory factors (TNF-a,IL-6,IL-8,IL-10,INF-gamma) were detected before and after the treatment;and the differences between the two groups were compared.Results After the treatment,the effective rate of the study group was 85.00％,which was significantly higher than that of the routine group (55.00％,P ＜ 0.05).There were no statistical differences in the levels of TNF-a,IL-6,IL-8,IL-10 and INF-gamma between the two groups before the treatment (all P ＞ 0.05);after the treatment,the levels of TNF-a,IL-6 and IL-8 were (31.22±6.72)ng/L,(30.34±7.49)ng/L,(0.24±0.11)μg/L significantly lower and the levels of IL-10 and INF-gamma were (43.41±7.93)μg/L,(33.24±6.1 l)μg/L significantly higher in the study group than in the routine group,with statistical differences (all P ＜ 0.05).The incidence of adverse reactions was 5.00％ in the study group and was 10.00％ in the conventional group,with no statistical difference (P ＞0.05).Conclusion Xiaochaihu decoction can improve the therapeutic effect of chronic hepatitis B combined with cholecystitis by improving the serum inflammatory factors,and has fewer adverse reactions.It is worth being recommended in clinical management.