消黄利胆汤联合穴位电刺激治疗对急性黄疸型肝炎患者肝功能及血液流变性的影响
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摘要
目的观察消黄利胆汤与穴位电刺激联合治疗急性黄疸型肝炎的疗效及对肝功能、血液流变性的影响,并探讨其作用机制。方法 126例患者按照随机数字表法分为观察组和对照组各63例。两组均给予常规保肝治疗,对照组给予穴位电刺激治疗,观察组在对照组基础上联合消黄利胆汤治疗。观察两组中医证候积分、临床疗效,检测总胆红素(TBil)、谷草转氨酸(GOT)、直接胆红素(DBil)、谷丙转氨酶(ALT)、血液流变学指标以及血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平。结果治疗后两组脘闷腹胀、身目俱黄、便溏不爽积分均低于治疗前(均P<0.05),且观察组均低于对照组(均P<0.05);观察组总有效率为92.06%,高于对照组的79.37%(P<0.05);治疗后两组TBil、AST、DBil、ALT水平均低于治疗前(均P<0.05),且观察组均低于对照组(均P<0.05);治疗后两组全血高切黏度、血浆黏度、血小板黏附率、全血低切黏度均低于治疗前(均P<0.05),且观察组均低于对照组(均P<0.05);治疗后两组TNF-α、IL-6水平均低于治疗前(均P<0.05),且观察组均低于对照组(均P<0.05)。结论消黄利胆汤联合穴位电刺激能够有效改善急性黄疸型肝炎患者临床症状和肝功能,降低血液流变性和炎症因子水平,提高临床疗效。
Objective: To observe the efficacy of Xiaohuang Lidan Decoction combined with acupoint electric stimulation on patients with acute icteric hepatitis and the influence on liver function and blood rheology. Methods: 126 cases of patients with acute icteric hepatitis were selected as the study objects,and divided into the observation group and the control group with random number table method,63 cases in each group. Both groups were given routine liver protection therapy,on the basis of which,the control group were given acupoint electrical stimulation therapy,and the observation group were added Xiaohuang Lidan Decoction. TCM symptom scores and clinical efficacy were observed,and total bilirubin(TBil),glutamic-oxaloa cetic transaminse(GOT),direct bilirubin(DBil),alanine aminotransferase(ALT),hemorheological indexes and serum tumor necrosis factor α(TNF-α),and interleukin-6(IL-6) level were detected in the two groups. Results: Abdominal distension nausea,yellow skin and eyes,loose stool integrals after treatment were significantly lower than those before treatment(P < 0.05),and those in the observation group were significantly lower than those in the control group(P < 0.05). The total effective rate of the observation group was 92.06%,significantly higher than that of the control group(79.37%)(P <0.05). After treatment,levels of TBil,GOT,DBil and ALT were significantly lower than those before treatment in the two groups(P < 0.05),and those in the observation group were significantly lower than those in the control group(P < 0.05). After treatment,whole blood viscosity,plasma viscosity,platelet adhesion rate,low blood viscosity were significantly lower than that before treatment in the two groups(P < 0.05),and those in the observation group were significantly lower than those in the control group(P < 0.05). After treatment,levels of TNF-α and IL-6 were significantly lower than those before treatment in the two groups(P < 0.05),and those in the observation group were significantly lower than those in the control group(P < 0.05). Conclusion: Xiaohuang Lidan Decoction combined with acupoint electric stimulation can effectively improve clinical symptoms and liver function of patients with acute icteric hepatitis,reduce blood rheology and inflammatory factor levels,and improve clinical efficacy.
Objective: To observe the efficacy of Xiaohuang Lidan Decoction combined with acupoint electric stimulation on patients with acute icteric hepatitis and the influence on liver function and blood rheology. Methods: 126 cases of patients with acute icteric hepatitis were selected as the study objects,and divided into the observation group and the control group with random number table method,63 cases in each group. Both groups were given routine liver protection therapy,on the basis of which,the control group were given acupoint electrical stimulation therapy,and the observation group were added Xiaohuang Lidan Decoction. TCM symptom scores and clinical efficacy were observed,and total bilirubin(TBil),glutamic-oxaloa cetic transaminse(GOT),direct bilirubin(DBil),alanine aminotransferase(ALT),hemorheological indexes and serum tumor necrosis factor α(TNF-α),and interleukin-6(IL-6) level were detected in the two groups. Results: Abdominal distension nausea,yellow skin and eyes,loose stool integrals after treatment were significantly lower than those before treatment(P < 0.05),and those in the observation group were significantly lower than those in the control group(P < 0.05). The total effective rate of the observation group was 92.06%,significantly higher than that of the control group(79.37%)(P <0.05). After treatment,levels of TBil,GOT,DBil and ALT were significantly lower than those before treatment in the two groups(P < 0.05),and those in the observation group were significantly lower than those in the control group(P < 0.05). After treatment,whole blood viscosity,plasma viscosity,platelet adhesion rate,low blood viscosity were significantly lower than that before treatment in the two groups(P < 0.05),and those in the observation group were significantly lower than those in the control group(P < 0.05). After treatment,levels of TNF-α and IL-6 were significantly lower than those before treatment in the two groups(P < 0.05),and those in the observation group were significantly lower than those in the control group(P < 0.05). Conclusion: Xiaohuang Lidan Decoction combined with acupoint electric stimulation can effectively improve clinical symptoms and liver function of patients with acute icteric hepatitis,reduce blood rheology and inflammatory factor levels,and improve clinical efficacy.
引文
[1]李妍.复方甘草酸苷注射液与前列地尔联合治疗急性黄疸型肝炎的临床效果研究[J].中国现代医生,2017,55(13):102-104.
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[8]张丽.茵虎退黄方联合茴三硫治疗黄疸型病毒性肝炎湿热瘀阻证的临床研究[D].成都:成都中医药大学,2013.
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[10]彭福江,张天晓,袁美蓉.复方甘草酸苷对慢性乙型肝炎患者肝功能、肝纤维化指标及炎症因子的影响[J].海南医学院学报,2017,23(4):485-488,492.
[11]李艺.加减健脾清化方联合干扰素治疗对慢性型肝炎脾虚湿盛证患者血清TNF-α、IL-6影响[D].郑州:河南中医学院,2015.
[12]汪四八,陈玉荣.泻热通腑汤保留灌肠治疗急性黄疸型肝炎临床研究[J].中医学报,2016,31(12):1984-1986.
[13]董双龙,李银彩,王飞.经皮穴位电刺激治疗甲型急性黄疸型肝炎的临床疗效[J].临床合理用药杂志,2016,9(3):106-108.
[14]樊亚巍.清热利湿活血法治疗急性黄疸型肝炎临床观察[J].中国中医急症,2013,22(7):1207-1208.
[15]张炯善,滕立春,杨宏志,等.利胆消黄汤对肝胆湿热型急性黄疸型肝炎患者的疗效观察[J].中药材,2015,38(3):651-652.
[2]左瑞菊,徐春军,邹济源.丹参注射液联合甘草酸二胺治疗黄疸型肝炎疗效观察[J].海南医学,2016,27(24):4001-4003.
[3]单思,聂鹏,席惠芳,等.中药治疗黄疸研究进展[J].世界中医药,2016,11(11):2486-2489.
[4]陈小莉.自制利胆退黄汤治疗黄疸型肝炎30例临床观察[J].浙江中医杂志,2016,51(7):497-498.
[5]中华医学会传染病与寄生虫病学分会,肝病学分会.病毒性肝炎防治方案[J].中华内科杂志,2001,40(1):62-68.
[6]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994.
[7]余波.血必净联合还原型谷胱甘肽治疗急性黄疸型肝炎疗效观察[J].肝脏,2013,18(5):355-356.
[8]张丽.茵虎退黄方联合茴三硫治疗黄疸型病毒性肝炎湿热瘀阻证的临床研究[D].成都:成都中医药大学,2013.
[9]中华人民共和国卫生部.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:228-229.
[10]彭福江,张天晓,袁美蓉.复方甘草酸苷对慢性乙型肝炎患者肝功能、肝纤维化指标及炎症因子的影响[J].海南医学院学报,2017,23(4):485-488,492.
[11]李艺.加减健脾清化方联合干扰素治疗对慢性型肝炎脾虚湿盛证患者血清TNF-α、IL-6影响[D].郑州:河南中医学院,2015.
[12]汪四八,陈玉荣.泻热通腑汤保留灌肠治疗急性黄疸型肝炎临床研究[J].中医学报,2016,31(12):1984-1986.
[13]董双龙,李银彩,王飞.经皮穴位电刺激治疗甲型急性黄疸型肝炎的临床疗效[J].临床合理用药杂志,2016,9(3):106-108.
[14]樊亚巍.清热利湿活血法治疗急性黄疸型肝炎临床观察[J].中国中医急症,2013,22(7):1207-1208.
[15]张炯善,滕立春,杨宏志,等.利胆消黄汤对肝胆湿热型急性黄疸型肝炎患者的疗效观察[J].中药材,2015,38(3):651-652.