凉血退黄法治疗肝内胆汁淤积性黄疸的临床研究

发布时间：2018-04-18 08:59

本文选题：肝内胆汁淤积 + 黄疸　；参考：《南京中医药大学》2016年硕士论文

【摘要】：研究目的：评价凉血退黄法对肝内胆汁淤积性黄疸的治疗效果。研究方法：将40例筛选出的符合肝内胆汁淤积性黄疸诊断的患者按照随机分配的原则,平均分成两组,分别为对照组的患者20例,治疗组的患者20例。对照组：口服熊去氧胆酸胶囊,每次1粒(250mg/-),每天3次,总疗程为4周。治疗组：在对照组基础上加用凉血退黄方,每天1剂,分两次口服, 疗程共4周。两组中原有抗病毒治疗的患者继续原抗病毒方案。每2周记录一次患者的肝功能指标及中医症候评分,将两组进行对照分析,依此来评价凉血退黄法的疗效。研究结果：①肝内胆汁淤积性黄疸可根据其发病机制可命名为“瘀热黄”。瘀热相搏是肝内胆汁淤积性黄疸的病机关键。凉血退黄是肝内胆汁淤积性黄疸的治疗大法。②从中医症候疗效评价分析,治疗组的总体有效率是80%,对照组的总体有效率是60%,两组存在明显差异(P0.05)。③在改善血清胆红素方面,治疗组的TBiL和DBiL水平在治疗后(第4周及治疗前比较)均明显降低,与治疗前比存在显著差异(P0.001)。治疗组治疗前后TBil值差与对照组相比,差异明显(p0.05)。④在改善GGT、ALP指标方面,治疗组及对照组的GGT、ALP水平在治疗前后(第4周及治疗前比较)有明显改善(均P0.001)。但对照组在治疗第2周时对GGT、ALP改善不明显,而治疗组第2周起对肝酶即有明显改善(p0.001)。结论：治疗组和对照组在降低患者血清胆红素及GGT、ALP、ALT、AST水平方面都有较好的治疗效果,并且在治疗过程中没有发现毒副作用的产生。治疗组对于降低血清胆红素、缓解胆汁淤积、改善肝功能的效果比对照组更为显著,对于中医临床症候的缓解更为有效。
[Abstract]:Objective: to evaluate the therapeutic effect of cooling blood and removing yellow on intrahepatic cholestatic jaundice.Methods: forty selected patients with intrahepatic cholestatic jaundice were randomly divided into two groups: control group (n = 20) and treatment group (n = 20).Control group: ursodeoxycholic acid capsules were given orally, 1 dose of ursodeoxycholic acid, 250 mg / L, 3 times a day, the total course of treatment was 4 weeks.Treatment group: on the basis of the control group, the treatment group was treated with the prescription of cooling blood and removing yellow blood, once a day, divided into two oral doses for 4 weeks.Two groups of patients with antiviral therapy continued proto-antiviral regimen.The liver function index and TCM symptom score were recorded every 2 weeks, and the two groups were compared and analyzed to evaluate the curative effect of cooling blood and removing yellow.Results the intrahepatic cholestatic jaundice can be named "stasis and heat yellow" according to its pathogenesis.Heat stasis is the key to the pathogenesis of intrahepatic cholestatic jaundice.From the evaluation of TCM symptoms, the total effective rate of the treatment group is 80, and the total effective rate of the control group is 60. There is a significant difference between the two groups in improving serum bilirubin.The levels of TBiL and DBiL in the treatment group were significantly decreased after treatment (4 weeks and before treatment), and there was a significant difference between before and after treatment (P 0.001).Compared with the control group, the difference of TBil between the treatment group and the control group was significant (p 0.054.The level of GGTN ALP in the treatment group and the control group was significantly improved before and after treatment (P 0.001).However, the control group had no significant improvement on GGTN ALP at the second week of treatment, while the treatment group had a significant improvement on liver enzyme from the second week after treatment (P 0.001).Conclusion: both the treatment group and the control group have better therapeutic effects in reducing serum bilirubin and GGT-ALP alt AST levels, and no side effects were found in the course of treatment.The effect of treatment group on reducing serum bilirubin, relieving cholestasis and improving liver function was more significant than that of control group.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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