桂枝茯苓丸加味治疗乙肝肝纤维化（瘀血阻络型）的临床观察

发布时间：2018-08-26 17:32

【摘要】：目的:观察桂枝茯苓丸加味对乙肝肝纤维化(瘀血阻络型)患者中医证候、肝功能、肝纤四项、门静脉内径、脾静脉内径、脾脏厚度、FIB-4指数的影响,评价桂枝茯苓丸加味治疗乙肝肝纤维化患者的疗效及安全性,并探讨其机制,为临床治疗乙肝肝纤维化提供新的治疗药物。方法:72例瘀血阻络型乙肝肝纤维化患者随机分为治疗组与对照组,各36例,治疗组给予桂枝茯苓丸加味;对照组口服大黄蛰虫胶囊,疗程均为12周。在疗程结束前后分别观察两组患者的中医证候、肝功能、肝纤四项、门静脉内径、脾静脉内径、脾脏厚度、FIB-4指数,比较两组的临床疗效,以P0.05认为有统计学意义。结果:1.总有效率:桂枝茯苓丸加味组治疗后总有效率84.4%,对照组总有效率为61.8%,差异有统计学意义,说明桂枝茯苓丸加味组治疗乙肝肝纤维化(瘀血阻络型)患者的临床疗效优于大黄蛰虫胶囊组;2.中医证候积分疗效:桂枝茯苓丸加味组治疗后总有效率93.8%,对照组总有效率为73.5%,差异具有统计学意义,说明桂枝茯苓丸加味组治疗乙肝肝纤维化(瘀血阻络型)患者的中医症候方面优于对照组;两组在纳呆、腹胀症状改善方面,差异具有统计学意义,说明桂枝茯苓丸加味组改善乙肝肝纤维化(瘀血阻络型)患者的纳呆、腹胀症状优于对照组;3.肝功能:比较治疗后两组改善患者肝功能指标方面,差异具有统计学意义,说明桂枝茯苓丸加味组在治疗乙肝肝纤维化(瘀血阻络型)患者肝功能方面优于对照组;4.肝纤四项:比较治疗后两组在改善患者肝纤四项情况时发现,两组血清Ⅳ型胶原指标差异具有统计学意义,而两组患者HA、LN、PⅢNP指标差异无统计学意义,说明桂枝茯苓丸加味组治疗患者血清Ⅳ型胶原指标方面优于对照组;5.彩超:对比治疗后两组彩超指数方面发现,在改善患者脾脏厚度方面,两组差异具有统计学意义,而在改善门静脉内径、脾静脉内径指标方面,两组差异没有统计学意义,说明桂枝茯苓丸加味组在改善患者的脾脏厚度方面优于对照组;6.FIB-4指数:治疗组与对照组均能明显降低患者的FIB-4指数,桂枝茯苓丸加味组在降低患者FIB-4指数方面优于对照组。结论:桂枝茯苓丸加味能有效的改善乙肝肝纤维化(瘀血阻络型)患者的临床症状、体征、肝功能、肝纤四项、彩超、FIB-4指数等,具有良好的临床疗效,且安全性良好,值得临床推广。
[Abstract]:Objective: to observe the effect of modified Guizhi Fuling Pill on TCM syndromes, liver function, liver fiber, portal vein diameter, spleen thickness and FIB-4 index in patients with hepatitis B liver fibrosis. To evaluate the efficacy and safety of Guizhi Fuling Pill in the treatment of hepatitis B liver fibrosis, and to explore its mechanism, and to provide a new therapeutic drug for clinical treatment of hepatitis B liver fibrosis. Methods 72 cases of liver fibrosis of hepatitis B with blood stasis and obstruction of collaterals were randomly divided into treatment group (n = 36) and control group (n = 36). Before and after the course of treatment, observe the TCM syndrome, liver function, liver fiber four, portal vein diameter, spleen thickness and FIB-4 index, compare the two groups of clinical efficacy, P0.05 that there is statistical significance. The result is 1: 1. Total effective rate: the total effective rate of the modified Guizhi Fuling pills group was 84.4, the total effective rate of the control group was 61.8, the difference was statistically significant. It shows that the clinical effect of Guizhi Fuling pill modified group is better than that of rhubarb Zhechong capsule group in treating hepatitis B liver fibrosis (blood stasis blocking collaterals type). The curative effect of TCM syndromes integral: the total effective rate of Guizhi Fuling Pill modified group was 93.8, the total effective rate of the control group was 73.5, the difference was statistically significant. The results showed that the traditional Chinese medicine symptom of the modified group of Guizhi Fuling pills was superior to the control group in the treatment of hepatitis B liver fibrosis (blood stasis blocking collaterals type), and the difference between the two groups in the symptoms of depression and abdominal distension was statistically significant. It shows that the modified group of Guizhi Fuling pills can improve the symptoms of abdominal distention in patients with hepatitis B liver fibrosis (blood stasis blocking collaterals), and the symptoms of abdominal distension are better than those of the control group. Liver function: the two groups improved the liver function after treatment, the difference was statistically significant, indicating that the modified group of Guizhi Fuling pills is superior to the control group in the treatment of liver fibrosis (blood stasis blocking collaterals type) liver function. 4. There were significant differences in serum collagen type 鈪，

本文编号：2205646