肝纤2号方治疗乙肝肝纤维化的临床研究

发布时间：2018-02-19 21:03

本文关键词： 肝纤2号方乙肝肝纤维化临床研究　出处：《广西中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:本研究主要是观察广西壮族自治区玉林市中医院肝胆病科治疗乙肝纤维化的协定方肝纤2号方的临床效果。方法:将符合慢性乙型病毒性肝炎后肝纤维化诊断标准的60例患者纳入研究观察,随机分为治疗组和对照组。治疗组30例,对照组30例,予恩替卡韦口服,睡前2小时口服,每天1次;治疗组在对照组基础上予肝纤2号方加减口服,每天2次。分别于治疗前、治疗后第24周观察两组患者总有效率、中医证候积分、肝功能生化学指标、血清肝纤四项指标、APRI指数、病毒学指标、肝脏彩超指标变化情况并且进行统计分析和疗效评价。结果:(1)总有效率比较:治疗组的总体有效率为83.33%,对照组的总有效率为63.33%,差异具有统计学意义(P0.05)。(2)中医证候积分比较:与治疗前比较,两组的中医证候积分均有所下降,差异有统计学意义(P0.05);两组间比较,治疗组较对照组下降明显,差异具有统计学意义(P0.05)。(3)肝功能比较:两组的ALT、AST、GGT、TBIL的下降幅度均较治疗前下降明显,差异有统计学意义(P0.05);两组间比较,治疗组的ALT、AST、GGT、TBIL的下降幅度均较对照组下降明显,差异有统计学意义(P0.05)。(4)肝纤维化比较:与治疗前相比较,两组肝纤维化的指标均有所下降,差异具有统计学意义(P0.05);两组间比较,治疗组的肝纤维化指标均较对照组下降明显,差异具有统计学意义(P0.05)。(5)APRI评分:治疗前,两组无显著差异(P0.05);经治疗,两组APRI评分均有显著降低,治疗组低于对照组,差异有统计学意义(P0.05)。(6)HBV-DNA比较:与治疗前比较,两组HBV-DNA的指标均有所下降,差异具有统计学意义(P0.05),两组的HBV-DNA对比无明显区别,差异无统计学意义(P0.05)。(7)肝脾B超比较:治疗后两组肝门静脉主干内径以及脾门厚度均低于治疗前,差异有统计学意义(P0.05),但是治疗组肝门静脉主干内径以及脾门厚度均低于对照组,差异有统计学意义(P0.05)。结论:肝纤2号方可以改善肝功能、降低肝纤四项指标、改善肝脏彩超程度、有较高的总有效率且无明显不良反应,但是由于本次观察时间较短,样本量较少,还需要进一步研究证实该方治疗乙肝肝纤维化的临床疗效。
[Abstract]:Objective: the purpose of this study was to observe the clinical effect of Fang Gan Xian 2 (Fang Gan Xian 2) in treating Hepatitis B Fibrosis in the Department of Hepatobiliary Diseases, Yulin Hospital of Guangxi Zhuang Autonomous region. Methods: liver fibrosis following chronic hepatitis B was carried out. A total of 60 patients with diagnostic criteria were included in the study. They were randomly divided into treatment group (n = 30) and control group (n = 30). The treatment group (n = 30) received entecavir orally 2 hours before bedtime once a day. Two times a day. The total effective rate, TCM syndrome score, liver function biochemical index, APRI index and virology index were observed before and 24 weeks after treatment, respectively. Results: the total effective rate of the treatment group was 83.33, and the total effective rate of the control group was 63.33. The difference was statistically significant (P0.05. Comparison: compared with before treatment, The scores of TCM syndromes of the two groups were all decreased, and the difference was statistically significant (P 0.05), and the difference between the treatment group and the control group was more obvious than that in the control group, and the difference was statistically significant compared with that of the control group (P 0.05). The liver function of the two groups was significantly lower than that of the control group, and the decrease range of alt ASTT GGTT TBIL in the two groups was significantly lower than that before treatment. Compared with the control group, the decrease of alt AST GGTT TBIL in the treatment group was significantly lower than that in the control group, and the difference was statistically significant (P 0.05. 05) the index of hepatic fibrosis in the treatment group was lower than that in the control group (P < 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05). Compared with the control group, the indexes of hepatic fibrosis in the treatment group were significantly lower than those in the control group, and the difference was statistically significant (P 0.05). There was no significant difference between the two groups before treatment (P 0.05). After treatment, the APRI scores of the two groups were significantly decreased. The HBV-DNA of the treatment group was lower than that of the control group (P 0.05). The HBV-DNA of the two groups was significantly lower than that of the control group (P 0.05). There was no significant difference in HBV-DNA between the two groups. Comparison of liver and spleen B ultrasound: after treatment, the diameter of the main portal vein and the thickness of the splenic portal vein in the two groups were lower than those before the treatment, and the difference was statistically significant (P 0.05), but the diameter of the main portal vein and the thickness of the splenic portal in the treatment group were lower than those in the control group. Conclusion: Ganxian 2 prescription can improve liver function, reduce liver fiber four indexes, improve liver color ultrasound degree, have higher total effective rate and no obvious adverse reaction, but because this observation time is short, The sample size is small, and further research is needed to confirm the clinical effect of this prescription on hepatitis B liver fibrosis.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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