疏肝健脾解毒方聯(lián)合恩替卡韋片治療肝郁脾虛、正虛邪戀型代償期乙肝肝硬化的臨床觀察
發(fā)布時間：2018-12-15 00:39
【摘要】：研究目的:通過觀察患者治療前后各項觀察指標(biāo)的變化情況,評價疏肝健脾解毒方治療肝郁脾虛、正虛邪戀型代償期乙肝肝硬化患者的臨床療效。研究方法:按納入標(biāo)準(zhǔn)和排除標(biāo)準(zhǔn)選取50例肝郁脾虛、正虛邪戀型代償期乙肝肝硬化患者,根據(jù)隨機(jī)數(shù)字表法簡單隨機(jī)分為中西藥組和純西藥組各25例。純西藥組予口服馬來酸恩替卡韋片(天丁),中西藥組在口服西藥基礎(chǔ)上加服疏肝健脾解毒方,療程均為12周。觀察治療前后兩組的中醫(yī)證候積分、多維疲勞量表得分(MFI-20)、肝功能、HBV-DNA指標(biāo)的變化情況及不良反應(yīng),評估MFI-20得分與肝功能的相關(guān)性。運(yùn)用統(tǒng)計學(xué)軟件SPSS20.0對全部數(shù)據(jù)進(jìn)行相關(guān)統(tǒng)計分析,對本方的臨床療效作出評價。研究結(jié)果:①中醫(yī)證候積分的比較:中西藥組、純西藥組組內(nèi)治療前后對比,證候積分均有下降,差異具有統(tǒng)計學(xué)意義(P0.05)。兩組治療前后積分差值對比,差異有統(tǒng)計學(xué)意義(P0.05),中西藥組中醫(yī)證候較純西藥組改善更為明顯。②兩組證候療效比較:中西藥組25例,治愈2例,顯效7例,有效13例,無效3例,總有效率88.00%;純西藥組25例,治愈0例,顯效3例,有效16例,無效6例,總有效率76.00%。中西藥組療效優(yōu)于純西藥組,差異具有統(tǒng)計學(xué)意義(P0.05)。③兩組肝功能比較:治療后中西藥組與純西藥組肝功能均較治療前有改善,差異具有統(tǒng)計學(xué)意義(P0.05);治療后兩組間肝功能比較,除白蛋白水平外,差異均有統(tǒng)計學(xué)意義(P0.05),且中西藥組改善程度優(yōu)于純西藥組。④兩組HBV-DNA比較:兩組治療后HBV-DNA水平均較治療前降低,差異具有統(tǒng)計學(xué)意義(P0.05);治療后兩組HBV-DNA水平比較,差異無統(tǒng)計學(xué)意義(P0.05),中西藥組在降低HBV-DNA水平上無明顯優(yōu)越性。⑤兩組MFI-20總分比較:兩組治療后MFI-20得分均較治療前降低,差異具有統(tǒng)計學(xué)意義(P0.01)。治療后,兩組間MFI-20總分比較,差異有統(tǒng)計學(xué)意義(P0.05),中西藥組得分較純西藥組下降更明顯。兩組心理疲勞、軀體疲勞、精神疲勞評分均較治療前下降,差異有統(tǒng)計學(xué)意義(P0.01)。治療后,中西藥組在軀體疲勞、精神疲勞評分較純西藥組改善程度更大,差異有統(tǒng)計學(xué)意義(P0.05)。⑥多維疲勞評分量表與肝功能的相關(guān)性分析:多維疲勞評分量表總分情況與肝功能(ALT、AST、TB)水平呈正相關(guān),具有統(tǒng)計學(xué)意義(P0.05)。多維疲勞評分量表總分情況與ALB無明顯相關(guān)性(P0.05)。研究結(jié)論:疏肝健脾解毒方治療肝郁脾虛、正虛邪戀型代償期乙肝肝硬化患者的臨床療效肯定,與單純西藥治療相比,可顯著改善患者疲勞癥狀,并能改善多維疲勞量表得分、肝功能、白蛋白、膽紅素、HBV-DNA等指標(biāo),提高臨床有效率,且臨床應(yīng)用安全性良好,值得推廣應(yīng)用。肝功能水平與多維疲勞量表得分呈正相關(guān),改善患者肝功能水平,可降低患者多維疲勞量表得分及改善患者疲勞癥狀。
[Abstract]:Objective: to evaluate the clinical efficacy of Shugan Jianpi jiedu recipe in treating patients with liver stagnation and spleen deficiency and compensatory hepatitis B cirrhosis by observing the changes of observation indexes before and after treatment. Methods: according to the inclusive criteria and exclusion criteria, 50 patients with liver stagnation and spleen deficiency, positive deficiency and evil love were selected. According to the method of random number table, they were divided into Chinese and western medicine group (25 cases) and pure western medicine group (25 cases). The pure western medicine group was treated with enticavir maleate tablets (Tianding), the Chinese and western medicine group was treated with Shugan Jianpi jiedu recipe on the basis of oral western medicine, the course of treatment was 12 weeks. The changes of TCM syndromes score, multi-dimensional fatigue scale (MFI-20), liver function, HBV-DNA index and adverse reactions were observed before and after treatment, and the correlation between MFI-20 score and liver function was evaluated. Statistical software SPSS20.0 was used to analyze all the data and evaluate the clinical effect. Results: 1 comparison of TCM syndromes integral: the traditional Chinese medicine group, pure western medicine group before and after treatment, syndromes integral decreased, the difference was statistically significant (P0.05). The difference between the two groups before and after treatment, the difference was statistically significant (P0.05), the TCM syndromes were improved more obviously in the traditional Chinese medicine group than in the pure western medicine group. 2 comparison of the curative effect of the two groups: 25 cases in the traditional Chinese medicine group, 2 cases in cure, 7 cases in remarkable effect, 2 cases in traditional Chinese medicine group, 2 cases in cure group, 7 cases in western medicine group. 13 cases were effective, 3 cases were ineffective, the total effective rate was 88.00%. There were 25 cases in pure western medicine group, 0 cases were cured, 3 cases were markedly effective, 16 cases were effective, 6 cases were ineffective, the total effective rate was 76.00%. The curative effect of Chinese and western medicine group was better than that of pure western medicine group, the difference was statistically significant (P0.05). 3 comparison of liver function between the two groups: after treatment, the liver function of Chinese and western medicine group and pure western medicine group were improved compared with that before treatment, the difference was statistically significant (P0.05); After treatment, there were significant differences in liver function between the two groups except albumin level (P0.05). And the improvement degree of Chinese and western medicine group is better than that of pure western medicine group. 4 comparison of HBV-DNA between the two groups: after treatment, the level of HBV-DNA in the two groups was lower than that before treatment, the difference was statistically significant (P0.05); There was no significant difference in the level of HBV-DNA between the two groups after treatment (P0.05). There was no obvious superiority in reducing the level of HBV-DNA in the Chinese and western medicine group. 5 comparison of total MFI-20 scores between the two groups: the MFI-20 scores of the two groups after treatment were lower than those before treatment. The difference was statistically significant (P0.01). After treatment, the total score of MFI-20 between the two groups, the difference was statistically significant (P0.05), the scores of Chinese and western medicine group than pure western medicine group decreased more significantly. The scores of mental fatigue, body fatigue and mental fatigue in the two groups were significantly lower than those before treatment (P0.01). After treatment, the scores of somatic fatigue and mental fatigue in the Chinese and western medicine group were better than those in the pure western medicine group. 6 correlation analysis between multidimensional fatigue score scale and liver function: the total score of multidimensional fatigue score scale was positively correlated with the level of liver function (ALT,AST,TB), and had statistical significance (P0.05). There was no significant correlation between the total score of multi-dimensional fatigue score and ALB (P 0.05). Conclusion: the clinical effect of Shugan Jianpi jiedu recipe in treating liver stagnation and spleen deficiency, positive deficiency and evil love in compensatory hepatitis B cirrhosis patients is definite. Compared with western medicine alone, it can significantly improve the fatigue symptoms of the patients and improve the scores of multidimensional fatigue scale. The indexes of liver function, albumin, bilirubin and HBV-DNA can improve the clinical effective rate, and the safety of clinical application is good, so it is worth popularizing. The level of liver function was positively correlated with the score of multi-dimensional fatigue scale. Improving the level of liver function could reduce the score of multi-dimensional fatigue scale and improve the fatigue symptoms of patients.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259
本文編號：2379615
[Abstract]:Objective: to evaluate the clinical efficacy of Shugan Jianpi jiedu recipe in treating patients with liver stagnation and spleen deficiency and compensatory hepatitis B cirrhosis by observing the changes of observation indexes before and after treatment. Methods: according to the inclusive criteria and exclusion criteria, 50 patients with liver stagnation and spleen deficiency, positive deficiency and evil love were selected. According to the method of random number table, they were divided into Chinese and western medicine group (25 cases) and pure western medicine group (25 cases). The pure western medicine group was treated with enticavir maleate tablets (Tianding), the Chinese and western medicine group was treated with Shugan Jianpi jiedu recipe on the basis of oral western medicine, the course of treatment was 12 weeks. The changes of TCM syndromes score, multi-dimensional fatigue scale (MFI-20), liver function, HBV-DNA index and adverse reactions were observed before and after treatment, and the correlation between MFI-20 score and liver function was evaluated. Statistical software SPSS20.0 was used to analyze all the data and evaluate the clinical effect. Results: 1 comparison of TCM syndromes integral: the traditional Chinese medicine group, pure western medicine group before and after treatment, syndromes integral decreased, the difference was statistically significant (P0.05). The difference between the two groups before and after treatment, the difference was statistically significant (P0.05), the TCM syndromes were improved more obviously in the traditional Chinese medicine group than in the pure western medicine group. 2 comparison of the curative effect of the two groups: 25 cases in the traditional Chinese medicine group, 2 cases in cure, 7 cases in remarkable effect, 2 cases in traditional Chinese medicine group, 2 cases in cure group, 7 cases in western medicine group. 13 cases were effective, 3 cases were ineffective, the total effective rate was 88.00%. There were 25 cases in pure western medicine group, 0 cases were cured, 3 cases were markedly effective, 16 cases were effective, 6 cases were ineffective, the total effective rate was 76.00%. The curative effect of Chinese and western medicine group was better than that of pure western medicine group, the difference was statistically significant (P0.05). 3 comparison of liver function between the two groups: after treatment, the liver function of Chinese and western medicine group and pure western medicine group were improved compared with that before treatment, the difference was statistically significant (P0.05); After treatment, there were significant differences in liver function between the two groups except albumin level (P0.05). And the improvement degree of Chinese and western medicine group is better than that of pure western medicine group. 4 comparison of HBV-DNA between the two groups: after treatment, the level of HBV-DNA in the two groups was lower than that before treatment, the difference was statistically significant (P0.05); There was no significant difference in the level of HBV-DNA between the two groups after treatment (P0.05). There was no obvious superiority in reducing the level of HBV-DNA in the Chinese and western medicine group. 5 comparison of total MFI-20 scores between the two groups: the MFI-20 scores of the two groups after treatment were lower than those before treatment. The difference was statistically significant (P0.01). After treatment, the total score of MFI-20 between the two groups, the difference was statistically significant (P0.05), the scores of Chinese and western medicine group than pure western medicine group decreased more significantly. The scores of mental fatigue, body fatigue and mental fatigue in the two groups were significantly lower than those before treatment (P0.01). After treatment, the scores of somatic fatigue and mental fatigue in the Chinese and western medicine group were better than those in the pure western medicine group. 6 correlation analysis between multidimensional fatigue score scale and liver function: the total score of multidimensional fatigue score scale was positively correlated with the level of liver function (ALT,AST,TB), and had statistical significance (P0.05). There was no significant correlation between the total score of multi-dimensional fatigue score and ALB (P 0.05). Conclusion: the clinical effect of Shugan Jianpi jiedu recipe in treating liver stagnation and spleen deficiency, positive deficiency and evil love in compensatory hepatitis B cirrhosis patients is definite. Compared with western medicine alone, it can significantly improve the fatigue symptoms of the patients and improve the scores of multidimensional fatigue scale. The indexes of liver function, albumin, bilirubin and HBV-DNA can improve the clinical effective rate, and the safety of clinical application is good, so it is worth popularizing. The level of liver function was positively correlated with the score of multi-dimensional fatigue scale. Improving the level of liver function could reduce the score of multi-dimensional fatigue scale and improve the fatigue symptoms of patients.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259
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