引火补土法联合熊去氧胆酸胶囊治疗原发性胆汁性肝硬化临床观察

发布时间：2018-01-21 14:08

本文关键词： 原发性胆汁性肝硬化引火补土法熊去氧胆酸胶囊疗效观察　出处：《湖北中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:观察引火补土法联合熊去氧胆酸胶囊治疗原发性胆汁性肝硬化(PBC)的临床疗效及安全性,探讨本病中医证的实质,揭示引火补土法作用机理,为临床治疗PBC提供新的治疗思路和方法。方法:采用随机对照临床试验方法,将2013年5月至2015年10月湖北省中医院肝病门诊及住院部就诊的原发性胆汁性肝硬化(中医证型属“肝肾不足,火不温土型”)患者随机分为两组:引火补土法联合UDCA治疗组、UDCA对照组,纳入统计分析的共50例。观察治疗1、3个月后两组肝功能指标、中医证候总积分、中医证候量化评分的变化,比较两组临床疗效。结果:1总体疗效比较:治疗1个月后,治疗组与对照组总有效率分别为57.69%、50.00%,差异无统计学意义(P0.05);治疗3个月后,治疗组总有效率为80.77%,对照组总有效率为62.50%,差异有统计学意义(P0.05)。2中医证候总积分比较:治疗1个月后,治疗组患者中医证候总积分(7.12±2.11)较治疗前(10.32±5.56)有明显改善,差异有统计学意义(P0.05),而对照组治疗前后中医证候总积分(治疗前为11.34±6.01、治疗后为10.23±3.13)差异无统计学意义(P0.05)。治疗3个月后,治疗组中医证候总积分为2.16±0.11,较治疗前明显降低,差异有统计学意义(P0.05);对照组治疗后中医证候总积分为5.42±1.18,较治疗前明显降低,差异有统计学意义(P0.05);治疗后中医证候总积分治疗组较对照组明显降低,差异有统计学意义(P0.05)。3中医证候量化评分比较:治疗1个月后,治疗组患者胁肋隐痛、腰膝酸软、黄疸、咽干口燥、骨蒸潮热、失眠多梦、下肢水肿、大便泄泻等中医证候量化评分较治疗前明显下降,差异有统计学意义(P0.05),而对照组仅胁肋隐痛、黄疸、下肢水肿等中医证候量化评分较治疗前下降明显,差异有统计学意义(P0.05),且治疗组患者腰膝酸软、黄疸、咽干口燥、骨蒸潮热、失眠多梦、下肢水肿、大便泄泻等中医证候量化评分较对照组明显降低,差异有统计学意义(P0.05);治疗3个月后,治疗组各中医证候量化较治疗前均有明显降低,差异有统计学意义(P0.05),而对照组仍有骨蒸潮热、口腔溃疡、失眠多梦、大便泄泻等中医证候量化评分较治疗前无明显降低,差异无统计学意义(P0.05),且治疗组患者骨蒸潮热、失眠多梦、口腔溃疡、大便泄泻等中医证候量化评分较对照组明显降低,差异有统计学意义(P0.05)。4肝功能指标比较:治疗1、3个月后,两组肝功能指标较治疗前均明显降低,差异有统计学意义(P0.05)。治疗1个月后,治疗组ALT、AST等肝功能指标较对照组明显降低,差异有统计学意义(P0.05),余肝功能指标两组比较差异无统计学意义(P0.05)。治疗3个月后,治疗组ALP、GGT、TBi L等肝功能指标较对照组下降明显,差异有统计学意义(P0.05),余肝功能指标两组比较差异无统计学意义(P0.05)。5安全性观察:治疗组和对照组治疗前后血液分析、尿液分析、粪便常规、肾功能、心电图等观测指标均无异常变化。结论:引火补土法联合UDCA治疗PBC较单纯西药治疗具有更好的疗效,在消除或缓解临床症状、改善肝功能方面表现出明显的优势。“肝肾不足,火不温土”是PBC的重要病机,采用引火补土法指导PBC的临床治疗安全有效,值得临床进一步研究。
[Abstract]:Objective: To observe the fire up indigenous Ursodeoxycholic Acid Capules for the treatment of primary biliary cirrhosis (PBC) clinical efficacy and safety of the essence of TCM syndrome, reveal the mechanism of indigenous fire up, with new ideas and methods for clinical treatment of PBC. Methods: using the method of randomized controlled clinical trials, May 2013 to October 2015 Hubei Provincial Traditional Chinese Medical Hospital outpatient and inpatient treatment of primary biliary cirrhosis (TCM "liver and kidney deficiency, fire temperature and soil type) were randomly divided into two groups: combined treatment of UDCA kindling up indigenous group, UDCA control group, included in the statistical analysis of 50 cases. Observation on the treatment of 1,3 two months after the group index of liver function, total score of TCM syndrome score, TCM syndrome changes, clinical efficacy of two groups were compared. Results: compared with the 1 overall curative effect: after 1 months of treatment, the treatment group and control group total efficiency Were 57.69%, 50%, the difference was not statistically significant (P0.05); after 3 months of treatment, the total efficiency of treatment group was 80.77%, control group total effective rate was 62.50%, the difference was statistically significant (P0.05).2 TCM syndrome total score: 1 months after treatment, the patients in the treatment group TCM syndrome the total score (7.12 + 2.11) than before treatment (10.32 + 5.56) was significantly improved, the difference was statistically significant (P0.05), and the control group before and after treatment of TCM syndrome total score (11.34 + 6.01 before treatment, after treatment was 10.23 + 3.13) there was no statistically significant difference (P0.05) for 3 months. After the treatment of TCM syndrome total score was 2.16 + 0.11, was significantly lower than that before treatment, the difference was statistically significant (P0.05); the control group after treatment of TCM syndrome total score was 5.42 + 1.18, was significantly lower than that before treatment, the difference was statistically significant (P0.05); after treatment, the total score of TCM syndrome the treatment group than the control group significantly reduced Low, the difference was statistically significant (P0.05).3 TCM Syndrome Scale: after 1 months of treatment, patients treated with flank pain, Yaoxisuanruan, jaundice, dry throat, osteopyrexia hot flashes, insomnia, lower extremity edema, diarrhea, TCM syndrome score than before treatment decreased significantly, there are statistically significant difference (P0.05), while the control group only flank pain, jaundice, edema of lower extremity and TCM syndrome score decreased significantly, the difference was statistically significant (P0.05), and the patients in the treatment group Yaoxisuanruan, jaundice, dry throat, osteopyrexia hot flashes, insomnia, lower extremity edema, diarrhea etc. TCM syndrome score significantly lower than the control group, the difference was statistically significant (P0.05); after 3 months of treatment, the treatment group TCM syndrome were lower than before the treatment, the difference was statistically significant (P0.05), while the control group still has the deficiency of hot flushes, oral ulcer Ulcers, insomnia, diarrhea, TCM syndrome score than before treatment significantly decreased, the difference was not statistically significant (P0.05), and the treatment group of patients with deficiency of hot flashes, insomnia, oral ulcers, diarrhea, TCM syndrome score significantly lower than the control group, the difference was statistically significant (P0.05.4) liver function index: 1,3 months after treatment, two groups of indexes of liver function were significantly lower than before treatment, the difference was statistically significant (P0.05). After 1 months of treatment, the treatment group ALT, AST and other indexes of liver function was significantly lower than the control group, the difference was statistically significant (P0.05), no significant residual liver the function index of the difference between the two groups (P0.05). After 3 months of treatment, the treatment group ALP, GGT, TBi, L and other indexes of liver function decreased significantly than the control group, the difference was statistically significant (P0.05), no significant residual liver function index difference between the two groups (P0.05).5 security Observation: treatment group and control group before and after treatment, blood analysis, urine analysis, stool routine, renal function, no abnormal changes in ECG observation index. Conclusion: the combination therapy of UDCA and PBC flash fill method compared with the pure western medicine treatment has better curative effect, to eliminate or alleviate symptoms, improve liver function showed obvious advantages "liver and kidney deficiency, fire and soil temperature is the important pathogenesis of PBC, using fire fill guide PBC treatment method is safe and effective, and is worthy of further study.

【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

【相似文献】