解毒化瘀温阳健脾与解毒化瘀益气健脾法治疗慢性重型肝炎的临床观察  

Clinical observation on chronic severe hepatitis treated by principles of detoxicating and stasising combined with warming-Yang and strengthening-Pi or combined with nourishing-Qi and strengthening-Pi

作　　者：伍玉南[1] 孙克伟[1] 彭建平[1] 陈斌[1] 黄裕红[1] 阳航[1] 朱文芳[1] 张涛[1] 陈兰玲[1] 

机构地区：[1]湖南中医药大学第一附属医院肝病中心湖南省中医药管理局重型肝炎证治研究室,湖南长沙410007

出　　处：《中西医结合肝病杂志》2011年第1期4-7,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：湖南省科技厅科技计划(No.2010FJ3153);国家科技重大专项"十一五"课题"慢性重型肝炎证候规律及中西医结合治疗方案研究"(No.2008ZX10052007);湖南省中医药科研基金资助(No.2008080)

摘　　要：目的:比较解毒化瘀、温阳健脾法与解毒化瘀、益气健脾法治疗慢性重型肝炎(慢重肝)湿热脾虚血瘀证(阴阳黄证)的临床疗效。方法:将56例慢重肝湿热脾虚血瘀证(阴阳黄证)患者分为两组,在解毒化瘀法治疗基础上分别加用附片、砂仁(温阳健脾组)与黄芪、白术(益气健脾组)治疗。结果:治疗4周,温阳健脾组和益气健脾组有效率分别为88.9%和73.1%。两组TBil均明显下降(P<0.01),温阳健脾组下降幅度较益气健脾组明显,治疗前后差值分别为(213.6±87.1)和(140.7±90.3)μmol/L,两组比较,P<0.05。PTA水平都有不同程度的升高,温阳健脾组PTA水平上升幅度大于益气健脾组,上升幅度均数比较,P<0.05。ALT水平治疗前后均明显降低(P<0.05),但两组间比较差异无显著性意义。温阳健脾组患者自发性腹膜炎发生率低于益气健脾组,未发现出血、黄疸进行性加深等不良反应。结论:温法干预治疗慢重肝阴阳黄证可提高疗效,且安全性较好。Objective：To observe the therapeutic efficacy and safety on chronic severe hepatitis（CSH） patients of Yanghuang and Yinhuang syndrome type by principles of detoxicating and stasising combined with warming-Yang and strengthening-Pi（PA）or with nourishing-Qi and strengthening-Pi（PB）,respectively.Methods：Fifty-six patients with CSH were randomly divided into two groups,group A（28 cases） treated with PA and group B（28 cases） with PB,for 4 weeks,level of serum bilirubin,PTA,ALT and adverse events were observed.Results：The efficient was 88.9%（24 /27）,73.1%（19 /26） in group A and group B respectively.Level of serum bilirubin was significantly lower in both groups,but the descending extent in group A was greater,compared with group B（213.6±87.1） and（140.7±90.3）μmol/L,respectively.The thrombinogen activity was higher in group A than that in group B after treatment（P0.05）,no significant difference in ALT was found between the two groups.The incidence of spontaneous bacterial peritonitis in group A（3/27） was less than that in group B（7/26）,no infection,bleeding and other adverse reactions was observed in group A.Conclusion： Warm therapy is efficacy and safety in patients with CSH with Yanghuang and Yinghuang syndrome type.

关 键 词：重型肝炎 慢性 阴阳黄证 解毒化瘀法/辨证治疗 附片/治疗应用 砂仁/治疗应用 

分 类 号：R259[医药卫生—中西医结合]