化痰祛瘀法治疗晚期血吸虫病（巨脾型）患者的临床观察

发布时间：2018-06-01 13:28

本文选题：祛瘀化痰 + 晚期血吸虫病　；参考：《湖北中医药大学》2016年硕士论文

【摘要】：目的以“痰瘀阻络”为晚期血吸虫病(巨脾型)核心病机,突出“痰瘀互结”这一关键病理改变,将祛瘀化痰法的治则应用于晚期血吸虫病患者,观察其临床疗效,为从痰瘀阻络辩证论治晚期血吸虫病(巨脾型)患者提供临床依据。方法研究对象为2014年3月至2016年2月至荆州市区血吸虫防治所就诊的晚期血吸虫病(巨脾型)患者,以纳入和排除标准筛选后,共纳入64例。按随机数字方式分为对照组和治疗组,各32例。将两组患者治疗前的肝功能、中医症候积分等相关指标进行统计学对比,证明两组患者各项指标无统计学差异后开始临床观察。对照组采用晚期血吸虫病(巨脾型)临床路径给予患者治疗:消除病因及诱因治疗、保肝治疗(如还原型谷胱甘肽、复方甘草酸单铵)及对症支持治疗。治疗组在对照组治疗方案基础之上给予以浙贝、漏芦、郁金、丹参为主方的中药颗粒剂口服治疗,随证加减。治疗三个月后记录两组患者的肝纤维化、肝功能、B超、中医症候积分等相关指标,并将治疗前后及两组之间的数据进行统计学分析,观察药物的疗效和毒副反应。结果两组患者治疗前后总体疗效对比及总体中医症候积分对比无显著差异;在脾厚、肝门静脉直径、ALT的改善上两组患者之间没有显著差异。治疗组在中医症候积分上对呕吐、腹胀、尿黄的改善明显优于对照组;对AST、TBil、白蛋白(A)、LN的改善明显优于对照组;治疗组的起效速度明显快于对照组。结论祛瘀化痰法能有效改善晚期血吸虫病(巨脾型)患者的AST、TBil、白蛋白(A)、LN指标,并能有效缓解呕吐、腹胀、尿黄症状。
[Abstract]:Objective to take "phlegm and stasis blocking collaterals" as the core pathogenesis of advanced schistosomiasis (giant spleen type), to highlight the key pathological change of "phlegm and blood stasis mutual knot", and to apply the method of removing blood stasis and removing phlegm to patients with advanced schistosomiasis, and to observe its clinical effect. To provide clinical basis for the treatment of advanced schistosomiasis (giant spleen type) from phlegm and blood stasis obstruction of collaterals. Methods from March 2014 to February 2016, 64 patients with advanced schistosomiasis (giant spleen type) were included in the study. The patients were randomly divided into control group (32 cases) and treatment group (32 cases). The two groups of patients before treatment of liver function, TCM symptom score and other related indicators were statistically compared, it was proved that the two groups of patients after no statistical differences in each index began to clinical observation. The patients in the control group were treated with advanced schistosomiasis (giant spleen type) by clinical pathway: eliminating the etiology and inducement, protecting liver (such as reduced glutathione, compound ammonium glycyrrhizinate) and symptomatic support therapy. Treatment group on the basis of the control group on the basis of the treatment of Zhejiang shellfish, leaky Reed, Tujin, Danshen prescription of traditional Chinese medicine granules oral treatment, plus or minus with the syndrome. After three months of treatment, the liver fibrosis, liver function, B-ultrasound, TCM symptom score and other related indexes were recorded, and the data before and after treatment and between the two groups were statistically analyzed to observe the curative effect and side effects of drugs. Results there was no significant difference in total curative effect and total TCM symptom score between the two groups before and after treatment, but there was no significant difference between the two groups in spleen thickness, hepatic portal vein diameter and alt improvement. The improvement of TCM symptom score on vomiting, abdominal distension and urine yellow in the treatment group was significantly better than that in the control group, and the improvement of ASTT TBiland Albumin in the treatment group was significantly better than that in the control group; the onset rate of the treatment group was obviously faster than that of the control group. Conclusion the method of removing blood stasis and removing phlegm can effectively improve ASTTBiland Albumin AtroLN in patients with advanced schistosomiasis (giant spleen type), and can effectively relieve the symptoms of vomiting, abdominal distension and urine yellow.
【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】