【摘要】：目的:觀察桂枝茯苓丸加味對乙肝肝纖維化(瘀血阻絡型)患者中醫(yī)證候、肝功能、肝纖四項、門靜脈內(nèi)徑、脾靜脈內(nèi)徑、脾臟厚度、FIB-4指數(shù)的影響,評價桂枝茯苓丸加味治療乙肝肝纖維化患者的療效及安全性,并探討其機制,為臨床治療乙肝肝纖維化提供新的治療藥物。方法:72例瘀血阻絡型乙肝肝纖維化患者隨機分為治療組與對照組,各36例,治療組給予桂枝茯苓丸加味;對照組口服大黃蟄蟲膠囊,療程均為12周。在療程結(jié)束前后分別觀察兩組患者的中醫(yī)證候、肝功能、肝纖四項、門靜脈內(nèi)徑、脾靜脈內(nèi)徑、脾臟厚度、FIB-4指數(shù),比較兩組的臨床療效,以P0.05認為有統(tǒng)計學意義。結(jié)果:1.總有效率:桂枝茯苓丸加味組治療后總有效率84.4%,對照組總有效率為61.8%,差異有統(tǒng)計學意義,說明桂枝茯苓丸加味組治療乙肝肝纖維化(瘀血阻絡型)患者的臨床療效優(yōu)于大黃蟄蟲膠囊組;2.中醫(yī)證候積分療效:桂枝茯苓丸加味組治療后總有效率93.8%,對照組總有效率為73.5%,差異具有統(tǒng)計學意義,說明桂枝茯苓丸加味組治療乙肝肝纖維化(瘀血阻絡型)患者的中醫(yī)癥候方面優(yōu)于對照組;兩組在納呆、腹脹癥狀改善方面,差異具有統(tǒng)計學意義,說明桂枝茯苓丸加味組改善乙肝肝纖維化(瘀血阻絡型)患者的納呆、腹脹癥狀優(yōu)于對照組;3.肝功能:比較治療后兩組改善患者肝功能指標方面,差異具有統(tǒng)計學意義,說明桂枝茯苓丸加味組在治療乙肝肝纖維化(瘀血阻絡型)患者肝功能方面優(yōu)于對照組;4.肝纖四項:比較治療后兩組在改善患者肝纖四項情況時發(fā)現(xiàn),兩組血清Ⅳ型膠原指標差異具有統(tǒng)計學意義,而兩組患者HA、LN、PⅢNP指標差異無統(tǒng)計學意義,說明桂枝茯苓丸加味組治療患者血清Ⅳ型膠原指標方面優(yōu)于對照組;5.彩超:對比治療后兩組彩超指數(shù)方面發(fā)現(xiàn),在改善患者脾臟厚度方面,兩組差異具有統(tǒng)計學意義,而在改善門靜脈內(nèi)徑、脾靜脈內(nèi)徑指標方面,兩組差異沒有統(tǒng)計學意義,說明桂枝茯苓丸加味組在改善患者的脾臟厚度方面優(yōu)于對照組;6.FIB-4指數(shù):治療組與對照組均能明顯降低患者的FIB-4指數(shù),桂枝茯苓丸加味組在降低患者FIB-4指數(shù)方面優(yōu)于對照組。結(jié)論:桂枝茯苓丸加味能有效的改善乙肝肝纖維化(瘀血阻絡型)患者的臨床癥狀、體征、肝功能、肝纖四項、彩超、FIB-4指數(shù)等,具有良好的臨床療效,且安全性良好,值得臨床推廣。
[Abstract]:Objective: to observe the effect of modified Guizhi Fuling Pill on TCM syndromes, liver function, liver fiber, portal vein diameter, spleen thickness and FIB-4 index in patients with hepatitis B liver fibrosis. To evaluate the efficacy and safety of Guizhi Fuling Pill in the treatment of hepatitis B liver fibrosis, and to explore its mechanism, and to provide a new therapeutic drug for clinical treatment of hepatitis B liver fibrosis. Methods 72 cases of liver fibrosis of hepatitis B with blood stasis and obstruction of collaterals were randomly divided into treatment group (n = 36) and control group (n = 36). Before and after the course of treatment, observe the TCM syndrome, liver function, liver fiber four, portal vein diameter, spleen thickness and FIB-4 index, compare the two groups of clinical efficacy, P0.05 that there is statistical significance. The result is 1: 1. Total effective rate: the total effective rate of the modified Guizhi Fuling pills group was 84.4, the total effective rate of the control group was 61.8, the difference was statistically significant. It shows that the clinical effect of Guizhi Fuling pill modified group is better than that of rhubarb Zhechong capsule group in treating hepatitis B liver fibrosis (blood stasis blocking collaterals type). The curative effect of TCM syndromes integral: the total effective rate of Guizhi Fuling Pill modified group was 93.8, the total effective rate of the control group was 73.5, the difference was statistically significant. The results showed that the traditional Chinese medicine symptom of the modified group of Guizhi Fuling pills was superior to the control group in the treatment of hepatitis B liver fibrosis (blood stasis blocking collaterals type), and the difference between the two groups in the symptoms of depression and abdominal distension was statistically significant. It shows that the modified group of Guizhi Fuling pills can improve the symptoms of abdominal distention in patients with hepatitis B liver fibrosis (blood stasis blocking collaterals), and the symptoms of abdominal distension are better than those of the control group. Liver function: the two groups improved the liver function after treatment, the difference was statistically significant, indicating that the modified group of Guizhi Fuling pills is superior to the control group in the treatment of liver fibrosis (blood stasis blocking collaterals type) liver function. 4. There were significant differences in serum collagen type 鈪，

本文編號：2205646