肝宁方治疗乙型肝炎肝硬化合并腹水30例临床观察  

Clinical efficacy of Ganning formula in treatment of hepatitis B virus-related cirrhosis with ascites: a report of 30 cases

作　　者：覃黎葵[1] 邓天好[2] 黄笑娟[3] 张亚琳[3] 

机构地区：[1]广州中医药大学热研所,广东广州510403 [2]湖南省中医药研究院附属医院,湖南长沙410006 [3]广州中医药大学祈福医院,广东广州511495

出　　处：《湖南中医杂志》2016年第7期4-6,共3页Hunan Journal of Traditional Chinese Medicine

基　　金：广东省中医药局资助项目(编号:20121273)

摘　　要：目的:观察肝宁方治疗乙型肝炎(简称"乙肝")肝硬化合并腹水的临床疗效。方法:将60例乙肝肝硬化合并腹水患者随机分为治疗组和对照组各30例。对照组予西医常规治疗,治疗组在对照组治疗的基础上加用肝宁方治疗,两组均治疗3周。观察两组患者的综合疗效及肝脾腹水情况,治疗前后的ALT、ALB、TBIL、HBV-DNA、肝纤4项、外周血一氧化氮(NO)及血浆血管紧张素Ⅱ(AngⅡ)含量的变化情况。结果:总有效率、显效率治疗组分别为90.00%、53.33%,对照组分别为66.67%、30.00%,组间比较,差异均有统计学意义(P<0.01)。显效病例腹水消退率治疗组为93.75%,对照组为44.44%,组间比较,差异有统计学意义(P<0.01)。治疗组在改善ALT、ALB、TBIL、肝纤4项、NO、AngⅡ水平方面均优于对照组,组间比较,差异有统计学意义(P<0.05)。结论:肝宁方能降低乙肝肝硬化腹水患者腹水量及改善肝功能、肝纤维化血清学指标,其作用机制可能与其明显降低肝炎肝硬化腹水患者血NO和AngⅡ水平有关。Objective： To investigate the clinical efficacy of Ganning formula in the treatment of hepatitis B virus（ HBV）- related cirrhosis with ascites. Methods： A total of 60 patients with HBV- related cirrhosis with ascites were randomly and equally divided into treatment group and control group. The control group was treated with conventional Western medicine therapy,and the control group was treated with Ganning formula in addition to the conventional Western medicine therapy. Both groups were treated for three weeks. The overall response rate and ascites in the liver and spleen of the two groups were observed,and the changes in alanine aminotransferase（ ALT）,albumin（ Alb）,total bilirubin（ TBil）,HBV- DNA,procollagen III（ Pc III）,collagen IV（ c IV）,laminin（ LN）,hyaluronidase（ HA）,peripheral nitric oxide（ NO）,and plasma angiotensin II（ Ang II） after treatment were compared between the two groups. Results： The overall response rate and marked response rate were 90. 00% and 53. 33%,respectively,in the treatment group,and were 66. 67% and 30. 00%,respectively,in the control group. There were significant differences in the two indices between the two groups（ P〈0. 01）. The remission rate of ascites among patients with marked response rate was 93. 75% in the treatment group and 44. 44% in the control group,with a significant difference between the two groups（ P〈0. 01）. The treatment group had significantly improved ALT,Alb,TBil,Pc III,c IV,LN,HA,NO,and Ang II compared with the control group（ P〈0. 05）. Conclusion： Ganning formula can alleviate ascites in patients with HBV- related cirrhosis with ascites,and can also improve liver function and serum fibrosis indices,probably by reducing peripheral NO and Ang II levels.

关 键 词：肝硬化 腹水 中西医结合疗法 肝宁方 

分 类 号：R259.752[医药卫生—中西医结合]