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加味归芍异功散治疗慢性乙肝肝纤维化肝脾两虚证的临床研究

The Clinical Research of Chronic Hepatitis B Hepatic Fibrosis Leading to Two Deficiency Syndrome of Liver and Spleen Treaded by Modified Gui Shao Yi Gong Powder

【作者】 孙延国

【导师】 傅雷;

【作者基本信息】 南京中医药大学 , 中医临床基础, 2012, 硕士

【摘要】 目的:观察加味归芍异功散治疗慢性乙肝肝纤维化肝脾两虚证的临床疗效,深化对肝脾相关理论的认识,并初步探讨肝纤维化的证治规律,以期规范中医药治疗该病的方法,提高临床疗效。方法:选取40例诊断为慢性乙肝肝纤维化的患者,将其随机分为两组。两组均应用复方甘草酸苷保肝治疗,治疗组(22例)服用拉米夫定、加味归芍异功散抗纤维化治疗;对照组(18例)仅用拉米夫定抗病毒,抗肝纤维化。每周复查一次肝功能,出院前复查肝纤维化三项,跟踪4周,观察两组患者治疗前后主要临床症状、体征、肝功能、肝纤维化三项指标的变化。评估加味归芍异功散抗肝纤维化治疗结束时的即时疗效。结果:治疗组显著缓解患者自觉症状、体征(p<0.05),改善肝功能(ALT.AST)指标(p<0.05);治疗组能显著改善肝纤三项中的HA.Ⅳ-C指标(p<0.05),对PCⅢ指标,治疗组虽能改善,但与治疗组对比无统计学差异(p>0.05)。结论:加味归芍异功散近期内能有效降低患者的肝纤维化指标,显著缓解患者的临床症状、体征,改善患者肝功能指标。提示我们柔肝健脾、活血化瘀法能有效缓解肝纤维化肝脾两虚型患者的临床症状、体征,改善患者实验室指标,值得进一步探讨和研究该法治疗肝纤维化的远期疗效。

【Abstract】 Objective:To observe the clinical effect of the application of modified Gui Shao Yi Gong powder in the treatment of chronic hepatitis B Hepatic Fibrosis leading to two deficiency syndrome of liver and spleen,to explore the relationship of liver and spleen, and the treatment principle of Hepatic Fibrosis.To give a standard for the treatment of this diease using Traditional Chinese medicine means,to improve the clinical effect.Methods:This study included40patients with chronic hepatitis B Hepatic Fibrosis,they were divided into two subgroups randomly,with the treatment group(22patients) taking modified Gui Shao Yi Gong powder additional;the contrast group (18patients) taking Western Medicine only.Both groups were interviewed every week and followed up for4weeks.Patients’ main clinical symptoms,indexes of liver function and Hepatic Fibrosis changes before and after treatment were then examined.Result:There is a significant difference (p<0.05) in improving symptoms,reducing laboratory indexes,but in reducing PC Ⅲ index,the results are not significant (p>0.05) Conclusion:modified Gui Shao Yi Gong powder can improve Patients’ main clinical symptoms,indcxes of liver function and Hepatic Fibrosis in the near future.Imply us the methods,nourishing liver and invigorating spleen, promoting blood circulation and removing blood stasis,can improve the Patients’ clinical symptoms,reduce the laboratory indexes,howerer it is worth further exploration and research.

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