膈下逐瘀汤联合西药治疗肝硬化肝脾血瘀证疗效分析
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Effect Analysis of Gexia Zhuyu Tang Combined with Western Medicine for Liver Cirrhosis with Blood Stasis of Liver and Spleen Syndrome
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    摘要:

    目的:观察膈下逐瘀汤联合西药治疗肝硬化肝脾血瘀证的临床疗效。方法:选取72例肝硬化肝脾血瘀证患者作为研究对象,按随机数字表法将患者分为观察组与对照组各36例。对照组单纯给予西药治疗,观察组在对照组西药基础上给予膈下逐瘀汤治疗,观察2组患者治疗前后中医证候积分、肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)、白蛋白(Alb)、总胆红素(TBil)]及肝纤维化指标[Ⅲ型前胶原氨基末端肽(PⅢP)、透明质酸(HA)、层粘连蛋白(LN)、Ⅳ型胶原蛋白(Ⅳ-C)]的变化,比较2组患者的临床疗效。结果:治疗后,2组胁肋刺痛、腹胀、蜘蛛痣、面色晦暗、倦怠乏力、纳差评分与中医证候总分均较治疗前降低(P<0.05),观察组各项中医证候评分与总分均低于对照组(P<0.05)。观察组总有效率为91.67%,对照组总有效率为66.67%,2组比较,差异有统计学意义(P<0.05)。2组AST、ALT、TBil水平均较治疗前降低,Alb水平均较治疗前上升,差异均有统计学意义(P<0.05);观察组AST、ALT、TBil水平均低于对照组(P<0.05),Alb水平高于对照组(P<0.05)。2组各项肝纤维化指标值均较治疗前降低(P<0.05),观察组各项肝纤维化指标值均低于对照组(P<0.05)。结论:在常规西药治疗基础上应用膈下逐瘀汤对肝硬化肝脾血瘀证患者进行治疗,较单纯西药治疗更能有效缓解患者的临床症状,改善患者的肝功能与肝纤维化情况,临床疗效显著。

    Abstract:

    Objective:To observe the clinical effect of Gexia Zhuyu tang combined with western medicine for liver cirrhosis with blood stasis of liver and spleen syndrome.Methods:Selected 72 cases of patients with liver cirrhosis with blood stasis of liver and spleen syndrome as study subjects,and divided them into the observation group and the control group according to random number table method,36 cases in each group.The control group was simply given western medicine for treatment,while the observation group was additionally given Gexia Zhuyu tang based on the treatment of the control group.Observed the changes of Chinese medicine syndrome scores,liver function indexes aspartate aminotransferase(ALT),alanine aminotransferase(AST),albumin(Alb),total bilirubin(TBil)and liver fibrosis indexes including procollagen Ⅲ propeptide(PⅢP),haluronic acid(HA),laminin(LN)and Ⅳ type collagen(Ⅳ-C)in two groups before and after treatment.Compared the clinical effect in both groups.Results:After treatment,scores of lateral thorax stabbing pain,abdominal distension,spider nevus,dim complexion,fatigue and weakness,and poor appetite as well as the total scores of Chinese medicine syndrome in both groups were all decreased when compared with those before treatment(P<0.05).Each Chinese medicine syndrome score and the total scores of Chinese medicine syndrome in the observation group were lower than those in the control group(P<0.05).The total effective rate was 91.67%in the observation group and was 66.67%in the control group,the difference being significant(P<0.05).Levels of AST,ALT and TBil in both groups were decreased when compared with those before treatment,while Alb levels were increased,differences being significant(P < 0.05).Levels of AST,ALT and TBil in the observation group were lower than those in the control group(P < 0.05),while the Alb levels were higher than those in the control group(P<0.05).Each value of liver fibrosis indexes in two groups was decreased when compared with that before treatment(P < 0.05),and each value of liver fibrosis indexes in the observation group was lower than that in the control group(P<0.05).Conclusion:Compared with the application of Gexia Zhuyu tang based on treatment of western medicine for liver cirrhosis with blood stasis of liver and spleen,simple western medicine can more effectively relieve clinical symptoms and improve the liver function and liver fibrosis of patients,which has significant clinical effect.

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张炜.膈下逐瘀汤联合西药治疗肝硬化肝脾血瘀证疗效分析[J].新中医,2018,50(4):78-81

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  • 在线发布日期: 2018-04-10
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