疏肝利胆活血法治疗慢性乙型病毒性肝炎合并慢性胆囊炎的临床研究

发布时间：2019-06-15 15:31

【摘要】：目的:观察疏肝利胆活血法治疗慢性乙型病毒性肝炎合并慢性胆囊炎的临床疗效,为临床研究和治疗提供参考。方法:选取江苏省中医院感染科门诊确诊为慢性乙型病毒型肝炎合并慢性胆囊炎、中医辩证分型为气滞血瘀型的患者60例,分为治疗组和对照组各30例,治疗组予中医疏肝利胆活血法治疗,对照组予口服茴三硫胶囊(每次1粒,每日3次),以4周为1个疗程,治疗4周、8周后观察两组患者的临床症状、实验室检查结果及超声影像学,利用统计学软件对其结果进行比较研究。结果:(1)症状比较:组内比较,治疗4周后与治疗前、治疗8周后与治疗前、治疗8周后与治疗4周后相比,治疗组与对照组症状总积分明显改善(P0.05),单项症状右胁疼痛、口苦咽干明显改善(P0.05)。组间比较,治疗8周后,治疗组在改善症状总积分方面明显优于对照组(P0.05),在改善右胁疼痛、口苦咽干、胸闷太息、右胁痛夜间加重方面明显优于对照组(P0.05)。(2)实验室检查比较:组内比较,治疗4周后与治疗前、治疗8周后与治疗前、治疗8周后与治疗4周后相比,治疗组与对照组AKP、GGT明显改善(P0.05)。组间比较,治疗8周后,治疗组改善AKP、GGT与对照组疗效相当(P0.05)。(3)B超检查比较:组内比较,治疗8周后与治疗4周后相比,治疗组胆囊壁增厚、胆汁透声差明显改善(P0.05)。组间比较,治疗8周后,治疗组对胆壁毛糙、胆汁透声差改善效果明显优于对照组(P0.05)。结论:疏肝利胆活血法治疗慢性乙型病毒性肝炎合并慢性胆囊炎气滞血瘀型患者,能改善患者的临床症状、肝功能、B超检查结果,尤其在右胁疼痛、右胁痛夜间加重、口苦咽干、胸闷太息症状及B超检查中胆壁毛糙、胆汁透声方面的改善有优势,延长使用时间可提高治疗效果;对于治疗慢乙肝合并胆囊炎的长期疗效,以及对病情的根本改善是否有效还需要进一步研究。
[Abstract]:Objective: To observe the clinical effect of dispersing stagnated liver-qi and promoting blood circulation in the treatment of chronic viral hepatitis B with chronic cholecystitis and to provide reference for clinical research and treatment. Methods:60 patients with chronic hepatitis B combined with chronic cholecystitis and traditional Chinese medicine were divided into treatment group and control group. The clinical symptoms, laboratory findings and ultrasonic imaging of the two groups were observed after 4 weeks and 8 weeks in the control group. The results of the two groups were compared and studied by using the statistical software. Results: (1) The symptoms of the treatment group and the control group were significantly improved after 4 weeks of treatment and 4 weeks after the treatment (P0.05). There was a significant improvement in the dry throat (P0.05). Compared with the control group (P0.05), the treatment group was better than the control group (P0.05) in the treatment group after 8 weeks of treatment, and it was better than the control group (P0.05). (2) Compared with the control group, the treatment group and the control group AKP and GGT were significantly improved after 8 weeks of treatment and 4 weeks after the treatment (P0.05). After 8 weeks of treatment, the treatment group improved the effect of AKP and GGT in the control group (P0.05). (3) The comparison of B-ultrasound examination: compared with the treatment group, the gallbladder wall of the treatment group was thickened and the sound of the bile was significantly improved after 8 weeks of treatment (P0.05). After 8 weeks of treatment, the treatment group was better than the control group after 8 weeks of treatment (P0.05). Conclusion: The treatment of chronic viral hepatitis B with qi stagnation and blood stasis with the effect of dispersing stagnated liver-energy and promoting blood circulation can improve the clinical symptoms, liver function and B-ultrasonic examination of patients. Especially in the right and hypochondrium, the right hand pain is aggravated at night and the mouth is bitter and dry. The symptoms of chest distress and the symptoms of the gallbladder wall in the B-mode ultrasound examination have the advantages of improving the use time and improving the treatment effect, and further research is needed for the long-term curative effect of the treatment of the chronic hepatitis B and the cholecystitis, and whether the fundamental improvement of the condition is effective.
【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】：2017
【分类号】：R259

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