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(shí)間：2018-12-15 00:39
【摘要】：研究目的:通過(guò)觀察患者治療前后各項(xiàng)觀察指標(biāo)的變化情況,評(píng)價(jià)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(jiǎn)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(lái)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(píng)估MFI-20得分與肝功能的相關(guān)性。運(yùn)用統(tǒng)計(jì)學(xué)軟件SPSS20.0對(duì)全部數(shù)據(jù)進(jìn)行相關(guān)統(tǒng)計(jì)分析,對(duì)本方的臨床療效作出評(píng)價(jià)。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(duì)比,證候積分均有下降,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組治療前后積分差值對(duì)比,差異有統(tǒng)計(jì)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(wú)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(wú)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(jì)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(jì)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(jì)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(jì)學(xué)意義(P0.05);治療后兩組HBV-DNA水平比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),中西藥組在降低HBV-DNA水平上無(wú)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(jì)學(xué)意義(P0.01)。治療后,兩組間MFI-20總分比較,差異有統(tǒng)計(jì)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(píng)分均較治療前下降,差異有統(tǒng)計(jì)學(xué)意義(P0.01)。治療后,中西藥組在軀體疲勞、精神疲勞評(píng)分較純西藥組改善程度更大,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。⑥多維疲勞評(píng)分量表與肝功能的相關(guān)性分析:多維疲勞評(píng)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(jì)學(xué)意義(P0.05)。多維疲勞評(píng)分量表總分情況與ALB無(wú)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(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R259
本文編號(hào)：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(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R259
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 趙治鳳;樊晉宇;張光謀;;1400例肝硬化患者流行病學(xué)分析[J];中國(guó)衛(wèi)生檢驗(yàn)雜志;2016年03期
2 林遠(yuǎn)燦;駱海鶯;陳紅淑;;垂盆草總黃酮對(duì)肝纖維化大鼠肝組織TGF-β 1和Smad7表達(dá)的影響[J];中國(guó)藥師;2015年12期
3 ;恩替卡韋臨床應(yīng)用專(zhuān)家共識(shí):2015年更新[J];中國(guó)肝臟病雜志(電子版);2015年02期
4 ;替諾福韋酯治療慢性HBV感染臨床應(yīng)用專(zhuān)家共識(shí)[J];中華實(shí)驗(yàn)和臨床感染病雜志(電子版);2015年01期
5 曹藝;;中醫(yī)思維對(duì)肝硬化病因病機(jī)認(rèn)識(shí)及治療運(yùn)用體會(huì)[J];亞太傳統(tǒng)醫(yī)藥;2014年21期
6 孫燕;屠紅;陸培新;王金兵;吳燕;張啟南;錢(qián)耕蓀;陳陶陽(yáng);;肝癌家族史與肝癌關(guān)系的20年前瞻性隊(duì)列研究[J];中華肝臟病雜志;2014年10期
7 陳子瑤;梁健;鄧鑫;;肝病實(shí)脾理論在乙肝肝硬化防治中的應(yīng)用[J];時(shí)珍國(guó)醫(yī)國(guó)藥;2013年12期
8 吳國(guó)春;成兆軍;王雄;;乙肝后肝硬化核苷類(lèi)藥物抗病毒治療期間發(fā)生原發(fā)性肝癌病因探討[J];江蘇醫(yī)藥;2013年23期
9 肖婷婷;郭倩;田成旺;張鐵軍;;抗運(yùn)動(dòng)性疲勞中藥及其復(fù)方的研究進(jìn)展[J];現(xiàn)代藥物與臨床;2013年03期
10 蔣菁蓉;張?zhí)旌?鐘森;;葉下珠治療慢性乙型肝炎研究概況[J];實(shí)用中醫(yī)內(nèi)科雜志;2013年04期
相關(guān)會(huì)議論文 前1條
1 劉珊;賈丹兵;李乃民;張永豐;;基于疲勞學(xué)的特征及分類(lèi)淺析[A];中國(guó)中西醫(yī)結(jié)合學(xué)會(huì)診斷專(zhuān)業(yè)委員會(huì)2009’年會(huì)論文集[C];2009年
相關(guān)碩士學(xué)位論文 前2條
1 葛艦;乙型肝炎肝硬化患者的疲勞特點(diǎn)及其與證候、肝功能指標(biāo)的相關(guān)性分析[D];北京中醫(yī)藥大學(xué);2014年
2 肖立寧;某部新兵疲勞調(diào)查及氨基酸維生素對(duì)軍事作業(yè)疲勞的預(yù)防作用[D];第二軍醫(yī)大學(xué);2011年
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