苦参碱对不同中医证型乙肝肝硬化疗效的临床观察  

Clinical Observation of the Efficacy of Matrine on Cirrhosis in Hepatitis B

作　　者：羌韧[1] 王越[2] 茅志娟[3] 达坤林[1] 秦刚[1] 章幼奕[1] 

机构地区：[1]江苏省南通市第三人民医院,江苏南通226006 [2]南京中医药大学,江苏南京210000 [3]南通市中医院,江苏南通226001

出　　处：《世界中西医结合杂志》2013年第9期933-935,共3页World Journal of Integrated Traditional and Western Medicine

基　　金：江苏省卫生厅青年科研项目(No.Q201208)

摘　　要：目的观察苦参碱治疗不同中医证型乙肝肝硬化患者的临床疗效。方法回顾性分析2012年4月～2013年3月在我院住院并符合纳入标准的患者共55例，根据中医辨证分为湿热型和非湿热型，治疗方案相同，比较两组的临床疗效。结果治疗4周后，湿热组有19例（79．17％）好转，非湿热组有12例（38．71％）好转，湿热组好转率优于非湿热组，两者比较，差异有统计学意义（P〈0．05）；两组治疗后的丙氨酸氨基转氨酶（ALT）、天门冬氨酸氨基转氨酶（AST）均有明显下降，湿热组患者的总胆红素（TBIL）、前白蛋白（PA）、凝血酶原时间（PT）改善明显（P〈0．01）。结论苦参碱治疗湿热型乙肝肝硬化患者，总体较非湿热型患者更有效，为临床选择适合的乙肝肝硬化患者进行苦参碱治疗提供参考，体现了中西医结合治疗的特色。Objective To observe the clinical efficacy of matrine on cirrhosis in hepatitis B differ-entiated as the different patterns/syndromes in traditional Chinese medicine （TCM）. Methods Fifty-five patients admitted from April 2012 to March 2013 were analyzed and enrolled as the qualified subjects. Ac-cording to the pattern/syndrome differentiation in TCM, the cases were differentiated into damp heat pattern and non - damp - heat pattern. The therapeutic program was same and the clinical efficacy was compared be-tween the two groups. Results In 4 weeks of treatment, 19 cases （79.17%） were improved in the damp - heat group and 12 cases （38.71% ）were improved in the non -damp -heat group. The improvement rate in the damp - heat group was better than that in the non - damp - heat group, indicating the significant differ-ence（ P 〈 0.05 ）. The levels of ALT and AST were reduced apparently after treatment in the two groups. The results in TBIL, PA and PT were improved obviously in the damp - heat group （P 〈 0.01 ）. Conclusion The overall efficacy of matrine is much higher in the patients of cirrhosis in hepatitis B of damp heat pattern/syn-drome as compared with those of non - damp - heat patterrL/syndrome. It provides the reference for the clini-cal treatment of cirrhosis in hepatitis B for the suitable patients and embodies the feature of integrated Chi-nese and western medicine.

关 键 词：乙型肝炎肝硬化 苦参碱 中医证型 

分 类 号：R572.2[医药卫生—消化系统] R512.62[医药卫生—内科学]