軟肝方治療乙肝肝硬化代償期（肝脾血瘀證）的臨床研究
發(fā)布時間：2019-03-04 09:05
【摘要】：目的:觀察軟肝方聯(lián)合恩替卡韋分散片治療肝脾血瘀證乙肝肝硬化代償期患者的臨床療效和用藥的安全性。方法:臨床選擇符合納入標(biāo)準(zhǔn)的慢性乙型肝炎肝硬化代償期患者60例,隨機分為兩組,治療組30例,對照組30例。最后完成試驗56例:治療組27例,對照組29例。脫落4例:治療組3例,對照組1例。治療組予軟肝方聯(lián)合恩替卡韋分散片口服;對照組予恩替卡韋分散片口服。連服3個月為1個療程。觀察兩組患者治療前后的臨床癥狀、體征、肝功能、肝纖維化指標(biāo)[透明質(zhì)酸(hyaluronic acid,HA)、層粘連蛋白(laminin,LN)、Ⅳ型膠原(Ⅳcollagen,Ⅳ-C)]、肝臟Fibroscan檢測值(FS值)、HBV DNA及腹部彩超(門靜脈內(nèi)徑、脾臟厚度、脾靜脈寬度)變化情況。所得數(shù)據(jù)采用SPSS19.0進(jìn)行統(tǒng)計處理。結(jié)果:臨床研究顯示,治療組總有效率為70.37%,與對照組比較,差異有統(tǒng)計學(xué)意義(P0.05)。治療組中醫(yī)證候總有效率81.48%,明顯優(yōu)于對照組,差異具有統(tǒng)計學(xué)意義(P0.05);治療組患者的倦怠乏力、納差癥狀較對照組改善明顯,差異有顯著統(tǒng)計學(xué)意義(P0.01),而脅下積塊、右脅刺痛、脘腹脹滿癥狀較對照組也有明顯改善,差異有統(tǒng)計學(xué)意義(P0.05)。治療后,治療組與對照組的HA、LN、Ⅳ-C指標(biāo)均顯著下降,治療組降低程度明顯優(yōu)于對照組,差異具有顯著統(tǒng)計學(xué)意義(P0.01)。治療組肝臟FS值療后較療前明顯降低,差異具有顯著統(tǒng)計學(xué)意義(P0.01),其與療后的對照組對比,差異有統(tǒng)計學(xué)意義(P0.05)。治療組肝功能AST、ALT治療后顯著降低,A/G顯著升高,兩組的AST、ALT、TBIL、A/G療后組間比較,差異有顯著統(tǒng)計學(xué)意義(P0.01)。治療后,兩組B超脾靜脈內(nèi)徑、脾厚、門靜脈內(nèi)徑寬度均較療前有所改善,但療后兩組間比較差異無統(tǒng)計學(xué)意義(P0.05)。兩組病例的HBV DNA載量療后較療前均有明顯下降,差異均有統(tǒng)計學(xué)意義(P0.05),但療后兩組間比較差異無統(tǒng)計學(xué)意義(P0.05)。安全性檢測:兩組病例的心電圖和血尿便常規(guī)等安全性指標(biāo)治療前后均未發(fā)現(xiàn)異常;兩組患者均無不良事件和不良反應(yīng)。結(jié)論:1、軟肝方能明顯降低肝脾血瘀證乙肝肝硬化代償期患者的肝纖維化(HA、LN、Ⅳ-C)水平及肝臟FS檢測值,有較好的抗肝纖維化作用,療效優(yōu)于單純恩替卡韋抗病毒治療。表明軟肝方有緩解肝硬化進(jìn)展的作用。2、軟肝方可有效降低患者肝功能ALT、AST、TBIL水平,提高A/G比值。3、軟肝方對臨床癥狀、體征的改善作用明顯優(yōu)于單純恩替卡韋抗病毒治療。
[Abstract]:Aim: to observe the clinical efficacy and safety of Ruangfang combined with entecavir dispersible tablet in the treatment of hepatitis B cirrhosis patients with liver and spleen blood stasis syndrome. Methods: 60 patients with chronic hepatitis B cirrhosis compensated period were selected and randomly divided into two groups: treatment group (n = 30) and control group (n = 30). Finally, 56 cases were completed: treatment group (27 cases) and control group (29 cases). 4 cases of shedding: 3 cases in the treatment group and 1 case in the control group. The treatment group was treated with Ruanganfang combined with entecavir dispersible tablets, while the control group was given enecavir dispersible tablets. Three months of continuous administration was a course of treatment. The clinical symptoms, signs, liver function, hepatic fibrosis indexes [hyaluronic acid (hyaluronic acid,HA), laminin (laminin,LN), type 鈪，
本文編號：2434132
[Abstract]:Aim: to observe the clinical efficacy and safety of Ruangfang combined with entecavir dispersible tablet in the treatment of hepatitis B cirrhosis patients with liver and spleen blood stasis syndrome. Methods: 60 patients with chronic hepatitis B cirrhosis compensated period were selected and randomly divided into two groups: treatment group (n = 30) and control group (n = 30). Finally, 56 cases were completed: treatment group (27 cases) and control group (29 cases). 4 cases of shedding: 3 cases in the treatment group and 1 case in the control group. The treatment group was treated with Ruanganfang combined with entecavir dispersible tablets, while the control group was given enecavir dispersible tablets. Three months of continuous administration was a course of treatment. The clinical symptoms, signs, liver function, hepatic fibrosis indexes [hyaluronic acid (hyaluronic acid,HA), laminin (laminin,LN), type 鈪，
本文編號：2434132
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