膈下逐瘀汤联合西药治疗乙型肝炎肝硬化代偿期临床观察
2017,49(10):52-54
摘要：目的:观察膈下逐瘀汤联合西药治疗乙型肝炎肝硬化代偿期患者的临床效果。方法:将95例乙型肝炎肝硬化代偿期气滞血瘀证患者随机分为治疗组50例和对照组45例,对照组给予常规西药抗病毒治疗,治疗组在对照组基础上加服膈下逐瘀汤治疗。治疗前后检测和比较2组肝功能指标[总胆红素(TBil)、白蛋白(Alb)、谷丙转氨酶(ALT)]、免疫功能指标[CD3~+、CD4~+、自然杀伤(NK)细胞活性]及肝纤维化指标[透明质酸酶(HA)、层粘连蛋白(LN)、Ⅳ型胶原(Ⅳ-C)、Ⅲ型前胶原(PCⅢ)],并评估2组治疗期间的用药安全性。结果:治疗后,2组TBil、Alb、ALT及HA、LN、Ⅳ-C、PCⅢ水平均较治疗前降低(P<0.05),CD3~+、CD4~+、NK细胞活性均较治疗前上升(P<0.05),治疗组10项指标的改善均优于对照组(P<0.05)。2组患者在治疗期间均未见明显过敏反应及其他不良反应。结论:采用膈下逐瘀汤联合西药治疗乙型肝炎肝硬化代偿期,可改善患者的肝功能,增强患者的免疫力,并可发挥显著的抗肝纤维化作用,从而预防血液高凝状态。
关键词：乙型肝炎; 肝硬化代偿期; 气滞血瘀证; 中西医结合疗法; 膈下逐瘀汤; 肝功能; 免疫功能; 肝纤维化;
Abstract：Objective：To observe the clinical effect of Gexia Zhuyu tang combined with western medicine for hepatitis B compensatory phase cirrhosis.Methods：Divided 95 cases of patients with hepatitis B compensatory phase cirrhosis of qi stagnation and blood stasis type into the treatment group with 50 cases and the control group with 45 cases randomly.Both groups received routine antiviral therapy of western medicine，while the treatment group was additionally treated with Gexia Zhuyu tang.Determined and compared liver function indexes[total bilirubin(TBil)，albumin(Alb)and alanine aminotransferase(ALT)]，immune function indexes[CD3+，CD4+and natural killer(NK)cell activity]as well as liver fibrosis indexes[hyaluronidase(HA)，laminin(LN)，type Ⅳ collagen(Ⅳ-C)and procollagen type Ⅲ(PCⅢ)]in both groups before and after treatment.Evaluated safety of medication in both groups during treatment.Results：After treatment，levels of TBil，Alb and ALT as well as levels of HA，LN，Ⅳ-C and PCⅢ in both groups were decreased when compared with those before treatment(P＜0.05)，while CD3+，CD4+and NK cell activity in both groups were increased when compared with those before treatment(P ＜0.05).Improvements of the ten indexes in the treatment group were superior to those in the control group，differences all being significant(P＜0.05).No case of allergy or other adverse reaction was found in both groups in the course of treatment.Conclusion：The therapy of Gexia Zhuyu tang combined with western medicine for hepatitis B compensatory phase cirrhosis can improve liver function and strengthen immunity of patients.It can exert significant effect of anti-liver fibrosis to prevent high blood coagulation.
Key words：Hepatitis B；Compensatory phase cirrhosis；Qi stagnation and blood stasis type；Integrated Chinese and western medicine therapy；Gexia Zhuyu tang；Liver function；Immune function；Liver fibrosis
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