肝病实脾对反复肝功异常慢乙肝患者生化指标和证候的影响
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摘要
目的:运用中医肝病实脾治法改善反复肝功异常未行抗病毒治疗的慢乙肝患者生化指标和症候,从而控制肝炎的发作。方法:在门诊患者中采用随机抽取60例e抗原阳性慢乙肝中度肝炎且未行抗病毒治疗且胃肠道证候明显的患者,对照组、观察组各30例。对照组采取口服五酯软胶囊+复方甘草酸苷片护肝降酶,观察组在对照组治疗方法基础上采用肝病实脾为主要治法的中药方剂加减,随访第4周观察两组患者治疗前后肝酶、胆红素变化水平,并随访第8周、第12周观察其肝酶、胆红素升高情况;胃肠道证候经治疗后按中医临床疗效评价指标——显效、有效、无效进行比较。结果:经研究表明,观察组肝酶、胆红素与对照组相比下降水平较高,随访第8周、第12周后其观察组肝酶出现反复升高的控制程度较对照组高。观察组证候改善与对照组相比,总有效率多于对照组。结论:肝病实脾,从中医治未病思想出发,见肝之病,知肝传脾,当先实脾,有效降低e抗原阳性慢乙肝肝酶、胆红素升高水平,改善肝炎所致的胃肠道证候反应,稳定肝内炎症活动。
Objective: To improve the biochemical and symptomatic symptoms of chronic hepatitis B( HBV) in patients,who did not receive antivial treatment,thus to control the onset of hepatitis. Methods: 60 HBV patients with obvious gastrointestinal reactions,who did not receive antivial treatment,were randomly divided into the control group( n = 30)and the observation group( n = 30). The control group was treated with Wuzhi Soft Capsule and Compound Glycyrrhizin Tablets; on which basis,the observation group was also treated with the formula based on the theroy of treating Liver disease by reinforcing Spleen. Liver enzyme and bilirubin levels were observed after 4 weeks of treatment,at 8-week follow-up and 12-week follow-up in the two groups. The gastrointestinal symptoms were compared according to the clinical efficacy evaluation index of TCM. Results: The decrease of the liver enzyme and bilirubin was more significant in the observation group,compared to the decreaes in the control group. The control of the liver enzymes was better in the observation group compared to that in the control group during follow-up. The total effective rate was higher in the observation group than that in the control group. Conclusion: The therapy of treating Liver disease by reinforcing Spleen can effectively reduce the level of the liver enzyme and bilirubin. It can improve the gastrointestinal reaction and stabilize intrahepatic inflammatory activity.
Objective: To improve the biochemical and symptomatic symptoms of chronic hepatitis B( HBV) in patients,who did not receive antivial treatment,thus to control the onset of hepatitis. Methods: 60 HBV patients with obvious gastrointestinal reactions,who did not receive antivial treatment,were randomly divided into the control group( n = 30)and the observation group( n = 30). The control group was treated with Wuzhi Soft Capsule and Compound Glycyrrhizin Tablets; on which basis,the observation group was also treated with the formula based on the theroy of treating Liver disease by reinforcing Spleen. Liver enzyme and bilirubin levels were observed after 4 weeks of treatment,at 8-week follow-up and 12-week follow-up in the two groups. The gastrointestinal symptoms were compared according to the clinical efficacy evaluation index of TCM. Results: The decrease of the liver enzyme and bilirubin was more significant in the observation group,compared to the decreaes in the control group. The control of the liver enzymes was better in the observation group compared to that in the control group during follow-up. The total effective rate was higher in the observation group than that in the control group. Conclusion: The therapy of treating Liver disease by reinforcing Spleen can effectively reduce the level of the liver enzyme and bilirubin. It can improve the gastrointestinal reaction and stabilize intrahepatic inflammatory activity.
引文
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[2]田甜,徐列明.丹参及其组分丹参酚酸B盐对门静脉高压小鼠肝脏微循环的影响[J].中西医结合学报,2009,7(2):151-156.
[3]Wu C,Wei C S,Yu S F,et al.Two new acetylated flavonoid glycosides from Phyllanthus urinaria[J].J Asian Nat Prod Res,2013,15(7):703-707.
[4]袁淑兰,王修杰.丹参酮抗肿瘤作用及其机理的研究[J].癌症,2003,22(12):1363-1366.
[5]邢宇锋,童光东,贺劲松,等.补肾清透方对慢性HBV携带者血清免疫因子的作用[J].传染病信息,2012,25(3):158-160.
[6]温洁.《金匮要略》肝病传脾与肝病实脾初探[J].四川中医,2014,32(6):1-3.
[7]叶柏.肝病实脾之我见[J].南京中医药大学报,2010,26(1):14-16.
[8]区鸿斌,陶衔玥,金伟孝,等.“见肝之病,知肝传脾,当先实脾”理论及其临床应用[J].中医杂志,2012,53(9):797-799.