通络消癥汤治疗乙肝肝硬化代偿期肝郁脾虚夹瘀证的临床效果观察
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摘要
目的 :探讨运用通络消癥汤治疗乙肝肝硬化代偿期肝郁脾虚夹瘀证的临床效果。方法 :选取2015年1月—2016年1月我院收治的81例乙肝肝硬化代偿期肝郁脾虚夹瘀证患者的临床资料,按治疗方案的不同分为观察组与对照组,对照组38例,采用常规的西药抗病毒治疗;观察组43例,在对照组基础上联合通络消癥汤(1剂/天,分早晚2次口服)治疗。比较两组的临床疗效、治疗前后肝功能、肝门脉内径与脾脏厚度、血清肝纤维化指标及不良反应情况。结果 :观察组治疗总有效率明显高于对照组,差异有统计学意义(P <0.05);治疗后两组证候积分均显著下降,且观察组显著低于对照组,差异有统计学意义(P <0.05);治疗后观察组肝功能及肝纤维化相关指标均显著优于对照组,差异有统计学意义(P <0.05);治疗后两组脾脏厚度及门脉内径均显著缩小,且观察组明显小于对照组,差异有统计学意义(P <0.05);两组均无明显不良反应发生。结论:通络消癥汤治疗乙肝肝硬化代偿期肝郁脾虚夹瘀证的疗效显著,且安全性较高,值得临床推广。
Objective: To investigate the clinical effect of tongluoxiaozheng decoction in treating syndromes of liver depression and spleen deficiency with stasis in the compensation period of hepatitis B cirrhosis. Methods: The clinical data of 81 patients with syndromes of liver depression and spleen deficiency with stasis in the compensation period of hepatitis B cirrhosis admitted to our hospital from January 2015 to January 2016 were selected. The patients were divided into an observation group and a control group according to different treatment options. 38 cases in the control group were given antiviral treatment with conventional Western medicine, and 43 cases in the observation group were treated with tongluoxiaozheng decoction(1 dose/day, 2 times in the morning and evening) on the basis of the control group. The clinical efficacy, liver function, hepatic portal vein diameter and spleen thickness, serum fibrosis indexes before and after treatment and adverse reactions were compared between the two groups. Results: The total effective rate in the observation group was significantly higher than that in the control group, with statistically significant difference(P<0.05). The syndrome scores in the two groups were significantly decreased after treatment, and the scores in the observation group were significantly lower than those in the control group, with statistically significant differences(P<0.05). The liver function and liver fibrosis-related indexes in the observation group were significantly better than those in the control group, with statistically significant differences(P<0.05). The spleen thickness and portal vein diameter in the two groups were significantly reduced after treatment, and these indexes in the observation group were significantly smaller than those in the control group, with statistically significant differences(P<0.05). There were no obvious adverse reactions in the two groups. Conclusion: The tongluoxiaozheng decoction is effective and safe in the treatment of syndromes of liver depression and spleen deficiency with stasis in the compensation period of hepatitis B cirrhosis, which is worthy of clinical promotion.
Objective: To investigate the clinical effect of tongluoxiaozheng decoction in treating syndromes of liver depression and spleen deficiency with stasis in the compensation period of hepatitis B cirrhosis. Methods: The clinical data of 81 patients with syndromes of liver depression and spleen deficiency with stasis in the compensation period of hepatitis B cirrhosis admitted to our hospital from January 2015 to January 2016 were selected. The patients were divided into an observation group and a control group according to different treatment options. 38 cases in the control group were given antiviral treatment with conventional Western medicine, and 43 cases in the observation group were treated with tongluoxiaozheng decoction(1 dose/day, 2 times in the morning and evening) on the basis of the control group. The clinical efficacy, liver function, hepatic portal vein diameter and spleen thickness, serum fibrosis indexes before and after treatment and adverse reactions were compared between the two groups. Results: The total effective rate in the observation group was significantly higher than that in the control group, with statistically significant difference(P<0.05). The syndrome scores in the two groups were significantly decreased after treatment, and the scores in the observation group were significantly lower than those in the control group, with statistically significant differences(P<0.05). The liver function and liver fibrosis-related indexes in the observation group were significantly better than those in the control group, with statistically significant differences(P<0.05). The spleen thickness and portal vein diameter in the two groups were significantly reduced after treatment, and these indexes in the observation group were significantly smaller than those in the control group, with statistically significant differences(P<0.05). There were no obvious adverse reactions in the two groups. Conclusion: The tongluoxiaozheng decoction is effective and safe in the treatment of syndromes of liver depression and spleen deficiency with stasis in the compensation period of hepatitis B cirrhosis, which is worthy of clinical promotion.
引文
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[8]徐雪芹.膈下逐瘀汤加味治疗肝炎肝硬化代偿期气滞血瘀证的临床价值分析[J].世界临床医学,2017,11(4):171.
[9]郝慧敏.通络消癥汤治疗乙肝肝硬化代偿期肝郁脾虚夹瘀证的临床观察[J].中国保健营养,2017,27(1):90-91.
[10]蒋先文.通络消癥汤治疗乙肝肝硬化代偿期肝郁脾虚夹瘀证的有效性[J].医药前沿,2017,7(7):347.
[2]陈兰玲.通络消癥汤治疗乙肝肝硬化代偿期肝郁脾虚夹瘀证的临床观察[J].湖南中医药大学学报,2015,35(7):43-46.
[3]徐庆年,汤伯宗,陆云飞,等.健脾软肝方治疗脾虚瘀结型失代偿期乙型肝炎肝硬化临床观察[J].上海中医药杂志,2015,49(10):39-41,45.
[4]姜付泉,薛晓琳,王天芳,等.乙型肝炎肝硬化患者中医证型与血清NPY的相关性研究[J].天津中医药,2015,32(1):10-14.
[5]武瑞美.养肝化瘀汤治疗乙型肝炎代偿期肝硬化气虚血瘀证的临床疗效分析[J].中外医疗,2016,35(25):179-181.
[6]武学臣.通络消癥汤治疗乙肝肝硬化代偿期肝郁脾虚夹瘀证的疗效[J].中西医结合心血管病电子杂志,2016,4(33):158-159.
[7]葛舰,王祖君,李小丹.乙型肝炎肝硬化患者疲劳状况与中医证候的关系研究——附632例临床资料[J].江苏中医药,2017,49(2):30-32.
[8]徐雪芹.膈下逐瘀汤加味治疗肝炎肝硬化代偿期气滞血瘀证的临床价值分析[J].世界临床医学,2017,11(4):171.
[9]郝慧敏.通络消癥汤治疗乙肝肝硬化代偿期肝郁脾虚夹瘀证的临床观察[J].中国保健营养,2017,27(1):90-91.
[10]蒋先文.通络消癥汤治疗乙肝肝硬化代偿期肝郁脾虚夹瘀证的有效性[J].医药前沿,2017,7(7):347.