| 柳诗意,张引强,郭朋,刘燕玲.不同活血化瘀法分阶段辨证干预乙肝肝纤维化的临床疗效研究[J].,2013,33(11):1457-1461 |
| 不同活血化瘀法分阶段辨证干预乙肝肝纤维化的临床疗效研究 |
| Intervention of Chronic Hepatitis B Liver Fibrosis Patients in Different Stages by Syndrome Typing and Different Activating Blood Removing Stasis Methods： a Clinical Study |
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| DOI：10.7661/CJIM.2013.11.1457 |
| 中文关键词: 肝纤维化 慢性乙型病毒性肝炎 活血化瘀 活血养血 活血软坚 |
| 英文关键词:liver fibrosis chronic hepatitis B activating blood removing stasis activating blood nourishing blood activating blood softening hard mass |
| 基金项目:中国中医科学院中医优势病种临床研究项目（No.CACMS07Y008） |
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| 中文摘要: |
| 目的观察不同活血化瘀法分阶段辨证干预乙肝肝纤维化的临床疗效。方法选取2008年7月—2011年12月期间在中国中医科学院西苑医院肝病科门诊就诊的正虚血瘀型乙肝肝纤维化患者100例，随机分为治疗组和对照组，每组50例。治疗组根据其病情轻、中、重的阶段不同，分别给予自拟方活血养血、活血化瘀、活血软坚3组汤药治疗，对照组则予中成药复方鳖甲软肝片治疗，统计两组治疗前后的中医证候积分、肝功能［主要为ALT、白蛋白/球蛋白（A/G）］、肝脏超声检查（主要包括肝脏回声、脾脏厚度、门静脉宽度）以及血清肝纤维化四项指标［包括血清透明质酸（HA）、层黏蛋白（LN）、Ⅳ型胶原（Ⅳ-C）、Ⅲ型前胶原蛋白肽（P-Ⅲ-P）］。疗程6个月。结果与本组治疗前比较，两组治疗后证候积分均降低，治疗组脾脏厚度较治疗前明显下降，差异有统计学意义（P<0.05）。与对照组同期比较，治疗组治疗后证候积分及脾脏厚度改善更明显，差异有统计学意义（P<0.05）。与治疗前比较，两组治疗后ALT、HA、LN显著下降，A/G显著升高，差异有统计学意义（P<0.05）。与对照组同期比较，治疗组治疗后A/G、HA、LN改善更为明显，差异有统计学意义（P<0.05）。治疗后治疗组与对照组疾病疗效总有效率分别为76%、46%，治疗组明显高于对照组 （P<0.05）。结论不同活血化瘀法分阶段辨证干预乙肝肝纤维化的疗效优于复方鳖甲软肝片，其对乙肝肝纤维化的临床症状及血清生化指标有良好的改善作用。 |
| 英文摘要: |
| ObjectiveTo observe the clinical efficacy of treating chronic hepatitis B liver fibrosis （CHBLF） in different stages by syndrome typing and different activating blood removing stasis methods （ABRSM）. MethodsTotally 100 CHBLF patients of vital qi deficiency blood stasis syndrome （VQDBSS） treated at the Department of Liver Diseases，Xiyuan Hospital， China Academy of Chinese Medical Sciences from July 2008 to December 2011， were randomly assigned to the treatment group and the control group， 50 in each group. Those in the treatment group were treated by self-formulated decoctions for activating blood nourishing blood （ABNB）， activating blood removing stasis （ABRS）， and activating blood softening hard mass （ABSHM） according to their stages of disease conditions （mild， moderate， and severe）. Those in the control group were treated with Compound Biejia Ruangan Tablet （CBRT）. Integrals of Chinese medical syndromes， liver functions ［mainly including alanine aminotransferase （ALT）， albumin/globumin （A/G）］， ultrasounographic examinations of liver （mainly including echoes of liver， width of spleens， width of portal vein）， four indicators of serum hepatic fibrosis［including serum hyaluronic acid （HA）， laminin （LN）， type Ⅳ collagen （Ⅳ-C）， type Ⅲ collagen peptide （P-Ⅲ-P）］ were statistically analyzed. The therapeutic course was 6 months for all. ResultsCompared with before treatment in the same group， the integrals of Chinese medical syndromes both decreased after treatment in the two groups （P<0.05）. The width of spleens decreased in the treatment group more obviously after treatment than before treatment （P<0.05）. Compared with the control group， the integrals of Chinese medical syndromes and the width of spleens were more obviously improved in the treatment group， showing statistical difference （P<0.05）. Compared with before treatment in the same group， levels of ALT， HA， and LN significantly decreased， and the level of A/G significantly increased after treatment in the two groups， showing statistical difference （P<0.05）. Compared with the control group， the A/G level， HA， and LN were more obviously improved in the treatment group， showing statistical difference （P<0.05）. The total effective rate was 76% in the treatment group and 46% in the control group， showing statistical difference （P<0.05）. ConclusionsTreating CHBLF in different stages by ABRSM got better effect than using CBRT alone. It could favorably improve clinical symptoms of CHBLF patients and their serum biochemical indicators. |
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