清肝解毒法治疗湿热毒瘀型慢性乙型肝炎的临床研究

发布时间：2018-04-28 14:13

本文选题：慢性乙型肝炎 + 临床研究　；参考：《黑龙江省中医药科学院》2016年硕士论文

【摘要】：目的:观察清肝解毒法治疗湿热毒瘀型慢性乙型肝炎的临床疗效,并探讨其有效性与作用机制,为临床治疗慢性乙型肝炎提供更有效的治疗方法。方法:纳入本研究确诊为湿热毒瘀型慢性乙型肝炎患者60例,随机分为治疗组和对照组,每组各30例。治疗组给予清肝解毒法组方的中药自拟方治疗,对照组采用复方蒂达胶囊治疗,疗程均为12周,疗后随访12~24周。观察治疗前后两组病例的临床症状体征、肝功、乙肝病毒定量、乙肝五项、肝脏彩超变化及相关安全性指标,以及治疗期间出现的不良反应。结果:治疗组临床综合疗效总有效率86.7%,对照组为66.7%,治疗组总体疗效更为显著(P0.05)。治疗组中医证候疗效总有效率83.3%,对照组为66.7%,治疗组明显优于对照组(P0.05)。治疗结束后,两组症状体征积分及总积分均减少(P0.05),治疗组缓解胁肋疼痛与口干口苦效果优于对照组(P0.05);两组ALT、AST、GGT、TBIL均显著下降(P0.01),治疗组在降低ALT方面优势明显(P0.01);两组HBV-DNA滴度均降低(P0.05),治疗组HBV-DNA滴度下降水平更明显(P0.05)。安全性指标未出现显著异常,无任何严重不良事件发生。结论:1.清肝解毒法可明显改善湿热毒瘀型慢性乙型肝炎患者的临床症状体征。2.清肝解毒法对于改善和恢复肝功能效果显著,有一定保护及修复肝细胞损伤的作用。3.清肝解毒法可在一定程度上降低患者乙肝病毒滴度值,有一定抑制及抗乙肝病毒复制的功效。
[Abstract]:Objective: to observe the clinical effect of clearing the liver and detoxification in treating chronic hepatitis B with damp-heat and toxin stasis, and to explore its effectiveness and mechanism, and to provide a more effective method for clinical treatment of chronic hepatitis B. Methods: 60 cases of chronic hepatitis B with damp-heat and toxin stasis type were randomly divided into treatment group and control group, 30 cases in each group. The treatment group was treated with traditional Chinese medicine prescription of Qinggan detoxification method, the control group was treated with compound Tida capsule, the course of treatment was 12 weeks, and the follow-up was 12 ~ 24 weeks after treatment. The clinical symptoms and signs, liver function, hepatitis B virus quantity, hepatitis B five items, liver color ultrasound changes and related safety indexes were observed before and after treatment, as well as adverse reactions during treatment. Results: the total effective rate was 86.7% in the treatment group and 66.7% in the control group. The overall curative effect of the treatment group was more significant than that of the control group (P 0.05). The total effective rate of TCM syndromes in the treatment group was 83.3%, and that in the control group was 66.7%, which was significantly better than that in the control group (P 0.05). After the treatment, The scores of symptoms and signs and the total scores of symptoms and signs in both groups were decreased (P 0.05), the effect of relieving rib pain and mouth dryness in the treatment group was better than that in the control group (P 0.05), and that in the treatment group, the level of GGTT TBIL in both groups was significantly lower than that in the control group (P 0.01), the advantage of the treatment group in reducing ALT was significant (P 0.01), and the titer of HBV-DNA in both groups was lower than that in the control group (P 0.05). The decrease of HBV-DNA titer was more obvious in the treatment group than that in the control group (P 0.05). No significant abnormality was found in safety indicators and no serious adverse events occurred. Conclusion 1. The method of clearing the liver and detoxifying can obviously improve the clinical symptoms and signs of chronic hepatitis B patients with damp-heat and toxin stasis. Qinggan detoxification method has a significant effect on improving and restoring liver function, and has the effect of protecting and repairing hepatocyte injury to a certain extent. The method of clearing the liver and detoxifying can reduce the titer of hepatitis B virus to a certain extent and has the effect of inhibiting and resisting the replication of hepatitis B virus.
【学位授予单位】：黑龙江省中医药科学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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