龙胆泻肝汤合小承气汤治疗酒精性肝炎（肝胆湿热证）的临床观察

发布时间：2018-07-31 20:17

【摘要】：目的:通过观察龙胆泻肝汤合小承气汤在治疗酒精性肝炎(肝胆湿热证)的临床疗效,以及将本方进行对症加减应用来探讨中医在治疗酒精性肝炎(以下简称AH)的疗效,通过统计学分析,客观的评价龙胆泻肝汤合小承气汤在治疗酒精性肝炎(肝胆湿热证)的临床有效性及安全性。方法:全部患者均来自长春中医药大学附属医院肝脾胃病科疗区及门诊,并符合纳入标准的60例酒精性肝炎(肝胆湿热证)的患者,采用随机对照分组法,分成治疗组和对照组,各30例。治疗组采用龙胆泻肝汤合小承气汤150ml/次,日2次口服,对照组采用肝毒净颗粒,8g/次,日3次冲服,两组疗程均为8周。观察其治疗前后中医症候积分的变化,检测并记录肝功能、消化系超声的变化。最后根据相应的疗效评价标准,做出评价。结果:所纳入的60例患者均按照治疗方案完成本次临床研究。疗效显示:治疗组30例患者,显效16例(53.33%),有效12例(40%),无效2例(6.67%),总有效率为93.33%;对照组30例,显效9例(30%),有效13例(53.33%),无效8例(26.67%),总有效率为83.33%,通过统计学分析,治疗组疗效优于对照组(P0.05)有统计学意义;两组在中医症状方面及改善肝功能、消化系超声等方面较治疗前均有改善,但治疗组使用的龙胆泻肝汤合小承气汤在AST、GGT方面优于使用肝毒净颗粒的对照组。在用药安全性方面,两组均未发现不良反应,运用龙胆泻肝汤合小承气汤安全性良好。结论:临床上应用龙胆泻肝汤合小承气汤治疗酒精性肝炎(肝胆湿热证),能明显改善患者的临床症状,促进肝功能的恢复,并减轻酒精性肝炎的程度。本方在试验过程中未见明显的不良反应及毒副作用,并且临床疗效满意,值得推广。
[Abstract]:Objective: to observe the clinical effect of Longdan Xiegan decoction combined with Xiaochengqi decoction in the treatment of alcoholic hepatitis (liver and gallbladder dampness and heat syndrome), and to explore the therapeutic effect of traditional Chinese medicine on alcoholic hepatitis (AH). Objective to evaluate the clinical efficacy and safety of Longdan Xiegan decoction and Xiaochengqi decoction in the treatment of alcoholic hepatitis (liver and gallbladder damp-heat syndrome). Methods: all the patients were from the Department of liver, spleen and stomach of the affiliated Hospital of Changchun University of traditional Chinese Medicine and outpatients, and 60 cases of alcoholic hepatitis (dampness and heat of liver and gallbladder) were included. They were divided into treatment group and control group with 30 cases in each group. The treatment group was treated with Longdan Xiegan decoction and Xiaochengqi decoction 150ml/ twice a day, while the control group was treated with Gandujing granule 8 g / time, 3 times a day. The course of treatment in both groups was 8 weeks. Observe the change of TCM symptom integral before and after treatment, detect and record the changes of liver function and digestive system ultrasound. Finally, according to the corresponding evaluation criteria, the evaluation is made. Results: the clinical study was completed in 60 patients according to the treatment protocol. The results showed that in the treatment group, 16 cases (53.33%) were significantly effective, 12 cases (40%) were effective, 2 cases (6.67%) were ineffective, the total effective rate was 93.33%, while in the control group, there were 30 cases (30%), 9 cases (30%), 13 cases (53.33%) were effective, 8 cases (26.67%) were ineffective, the total effective rate was 83.33%, and the total effective rate was 83.33%. The curative effect of the treatment group was better than that of the control group (P0.05). But the Gentian Xiegan decoction combined with Xiaochengqi decoction in the treatment group was superior to the control group in terms of GGT. There were no adverse reactions in both groups, and the safety of Gentian Xiegan decoction and Xiaochengqi decoction was good. Conclusion: the clinical application of Longdan Xiegan decoction and Xiaochengqi decoction in the treatment of alcoholic hepatitis (damp-heat syndrome of liver and gallbladder) can obviously improve the clinical symptoms of the patients, promote the recovery of liver function, and reduce the degree of alcoholic hepatitis. There were no obvious adverse reactions and side effects in the trial, and the clinical effect was satisfactory. It is worth popularizing.
【学位授予单位】：长春中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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