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(1)
[摘要] 目的 探讨养肝化瘀汤治疗乙型肝炎代偿期期肝硬化的临床疗效。 方法 方便选取该院自2010年9月—2015年12月住院的60例乙型肝炎代偿期肝硬化患者，随机分为治疗组(30例)和对照组(30例)，治疗组给予养肝化瘀汤，对照组给予还原性谷胱甘肽片，疗程3个月，观察治疗前后两组B超检查结果、肝功能、肝纤维化指标治疗前后改善情况。结果 治疗组总有效率为80%优于对照组总有效率为66.7% (P<0.05)；经治疗后，治疗组HA、PⅢP、LN、ALT、AST、Ⅳ-C分别为(65.57±9.838)μg/L、(14.40±9.543)n/g、(115.95±39.792)kDa、(54.44±32.713)pmol/L、(51.52±31.245)IU/L、(47.13±13.329) ng/mL优于对照组(P<0.05)；B超结果比较，治疗前后，两组间差异有统计学意义(P<0.05)。 结论 养肝化瘀汤在一定程度上可减小门静脉内径、脾脏厚度，优于单纯用还原型谷胱甘肽治疗。
[关键词] 养肝化瘀汤；乙肝代偿期肝硬化；疗效观察
[中图分类号] R246.1；R917 [文献标识码] A [文章编号] 1674-0742(2016)09(a)-0179-03
[Abstract] Objective To investigate the clinical effect of Huayu Decoction in the treatment of decompensated liver cirrhosis of hepatitis B. Methods Convenient selection to our hospital since September 2010 to December 2015 my division hospitalization of 60 cases of decompensated hepatitis B cirrhosis patients were randomly divided into the treatment group (30 cases) and control group (30 cases)， the treatment group give Yanggan decoction， the control group was treated with reduced glutathione tablets， treatment for 3 months observed before and after treatment in two groups the results of ultrasonic examination， liver function， hepatic fibrosis indexes before and after treatment to improve the situation. Results The treatment group total effective rate was 80% higher than control group， the total effective rate was 66.7% (P < 0.05)； after treatment， treatment group HA， P IIIP， LN， ALT， AST， IV-C were (65.57 ± 9.838) μg/L， (14.40± 9.543) n/g， (115.95 ± 39.792) kDa， (54.44 ± 32.713) pmol / L， (51.52 ± 31.245) IU/L， (47.13±13.329) ng/mL is better than that of the control group(P < 0.05)； ultrasound results， before and after the treatment， between the two groups have significant difference(P < 0.05). Conclusion Yanggan Decoction in a certain extent can be reduced wicket vein， thickness of spleen， is better than that only using glutathione therapy.
[Key words] Yanggan Decoction ； Hepatitis B cirrhosis； Curative effect observation
Decoction乙型肝炎肝硬化是慢性乙型肝炎发展的终末期病理转归，一旦发展到失代偿期和(或)肝癌，预后往往较差[1]。近年来，国内研究者应用中医药治疗乙型肝炎代偿期肝硬化，无论从病因病机，还是从治疗方法上都取得了较大进展。该院自2010年9月—2015年12月采用养肝化瘀汤对代偿期肝硬化患者60例，取得了较好的疗效，现报道如下。
1 资料与方法
1.1 一般资料
方便选取该院收治的60例患者均为该院内二科住院病例，随机分为对照组和治疗组，其中治疗组30例，年龄30～51岁，男24例，女6例；对照组30例，年龄30～53岁，男25例，女5例，两组性别、年龄等资料差异无统计学意义(P>0.05)，均具有可比性。
1.2 入选标准
①病因诊断：慢性乙型肝炎病史；HBV-M阳性且未合并感染他种肝炎病毒。②临床表现：乏力、食欲减退、腹胀、肝区不适；肝病面容(面色黝黑无光泽)，肝脾轻度肿大可触及(肋下一横指)，质软而边缘钝，无触痛。③实验室检查：血清ALT和(或)AST正常或轻度升高，血清透明质酸(HA)、Ⅳ型胶原(Ⅳ-C)、Ⅲ型前胶原肽(PⅢP)、层黏连蛋白(LN)其中至少两项增高。④辅助检查：B超提示肝脏表面欠光滑、肝实质回声不均匀；肝门静脉主干内径≥1.4 cm；脾静脉内径≥0.8 cm。脾脏厚度≥4.0 cm[2]。 (武瑞美)
[关键词] 养肝化瘀汤；乙肝代偿期肝硬化；疗效观察
[中图分类号] R246.1；R917 [文献标识码] A [文章编号] 1674-0742(2016)09(a)-0179-03
[Abstract] Objective To investigate the clinical effect of Huayu Decoction in the treatment of decompensated liver cirrhosis of hepatitis B. Methods Convenient selection to our hospital since September 2010 to December 2015 my division hospitalization of 60 cases of decompensated hepatitis B cirrhosis patients were randomly divided into the treatment group (30 cases) and control group (30 cases)， the treatment group give Yanggan decoction， the control group was treated with reduced glutathione tablets， treatment for 3 months observed before and after treatment in two groups the results of ultrasonic examination， liver function， hepatic fibrosis indexes before and after treatment to improve the situation. Results The treatment group total effective rate was 80% higher than control group， the total effective rate was 66.7% (P < 0.05)； after treatment， treatment group HA， P IIIP， LN， ALT， AST， IV-C were (65.57 ± 9.838) μg/L， (14.40± 9.543) n/g， (115.95 ± 39.792) kDa， (54.44 ± 32.713) pmol / L， (51.52 ± 31.245) IU/L， (47.13±13.329) ng/mL is better than that of the control group(P < 0.05)； ultrasound results， before and after the treatment， between the two groups have significant difference(P < 0.05). Conclusion Yanggan Decoction in a certain extent can be reduced wicket vein， thickness of spleen， is better than that only using glutathione therapy.
[Key words] Yanggan Decoction ； Hepatitis B cirrhosis； Curative effect observation
Decoction乙型肝炎肝硬化是慢性乙型肝炎发展的终末期病理转归，一旦发展到失代偿期和(或)肝癌，预后往往较差[1]。近年来，国内研究者应用中医药治疗乙型肝炎代偿期肝硬化，无论从病因病机，还是从治疗方法上都取得了较大进展。该院自2010年9月—2015年12月采用养肝化瘀汤对代偿期肝硬化患者60例，取得了较好的疗效，现报道如下。
1 资料与方法
1.1 一般资料
方便选取该院收治的60例患者均为该院内二科住院病例，随机分为对照组和治疗组，其中治疗组30例，年龄30～51岁，男24例，女6例；对照组30例，年龄30～53岁，男25例，女5例，两组性别、年龄等资料差异无统计学意义(P>0.05)，均具有可比性。
1.2 入选标准
①病因诊断：慢性乙型肝炎病史；HBV-M阳性且未合并感染他种肝炎病毒。②临床表现：乏力、食欲减退、腹胀、肝区不适；肝病面容(面色黝黑无光泽)，肝脾轻度肿大可触及(肋下一横指)，质软而边缘钝，无触痛。③实验室检查：血清ALT和(或)AST正常或轻度升高，血清透明质酸(HA)、Ⅳ型胶原(Ⅳ-C)、Ⅲ型前胶原肽(PⅢP)、层黏连蛋白(LN)其中至少两项增高。④辅助检查：B超提示肝脏表面欠光滑、肝实质回声不均匀；肝门静脉主干内径≥1.4 cm；脾静脉内径≥0.8 cm。脾脏厚度≥4.0 cm[2]。 (武瑞美)