败黄肝宁合剂联合丁二磺酸腺苷蛋氨酸肠溶片分型论治慢性乙型肝炎肝硬化黄疸的疗效观察  

Clinical observation of Baihuang Ganning mixture combined with Ademetionine 1,4-Butanedisulfonate Enteric Coated Tables on Hepatitis B cirrhosis jaundice

作　　者：李桂珍[1] 付亚 胡伟[1] 时昭红[1] 

机构地区：[1]湖北省武汉市第一医院消化内科,湖北武汉430022 [2]湖北中医药大学

出　　处：《河北中医》2018年第1期78-82,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：2011年度武汉市卫生局临床医学科研项目科研基金资助项目(编号:WZ11Z02)

摘　　要：目的观察败黄肝宁合剂联合丁二磺酸腺苷蛋氨酸肠溶片分型论治慢性乙型肝炎(以下简称乙肝)肝硬化黄疸的临床疗效。方法选取100例乙肝肝硬化黄疸患者为研究对象,按照中医证型不同分为湿热瘀阻证、气滞血瘀证、肝郁脾虚证及肝肾阴虚证4组,每组25例,均以败黄肝宁合剂联合丁二磺酸腺苷蛋氨酸肠溶片治疗。4组均治疗4周后统计疗效,并比较各组治疗前后肝功能指标总胆红素(TBi L)、碱性磷酸酶(ALP)、总胆汁酸(TBA)及γ-谷氨酰转肽酶(γ-GT)水平变化,随访8周观察长期疗效。结果湿热瘀阻证组总有效率88.0%,气滞血瘀证组总有效率52.0%,肝郁脾虚证组总有效率52.0%,肝肾阴虚证组总有效率48.0%,湿热瘀阻证组疗效最佳(P<0.05);4组治疗后TBi L、ALP、TBA及γ-GT水平与本组治疗前比较均明显降低(P<0.05),且湿热瘀阻证组治疗后TBi L、ALP、TBA及γ-GT水平均低于其他3组(P<0.05);4组治疗后8周时TBi L、ALP、TBA及γ-GT水平与本组治疗结束时比较差异均无统计学意义(P>0.05),湿热瘀阻证组治疗后8周时TBi L、ALP、TBA及γ-GT水平均低于其他3组(P<0.05)。结论败黄肝宁合剂联合丁二磺酸腺苷蛋氨酸肠溶片对不同中医证型的乙肝肝硬化黄疸均具有一定的疗效,可明显改善患者肝功能,降低TBi L、ALP、TBA及γ-GT水平,且长期疗效稳定,但以湿热瘀阻证患者疗效最佳。Objective To observe the clinical effects of Baihuang Ganning mixture combined with Ademetionine 1,4-butanedisulfonate enteric coated tables on Hepatitis B cirrhosis jaundice. Methods 100 patients with hepatitis B cirrhosis jaundice were selected as study subjects,and divided into four groups according to different types of TCM syndromes: damp-heat-stasis syndrome,qi-stagnation and blood-stasis syndrome,liver-depression and spleen-deficiency syndrome and yin deficiency of liver and kidney syndrome,and 25 cases in each group,and all cases were treated by Baihuang ganning mixture combined with Ademetionine 1,4-butanedisulfonate enteric coated tables. The curative effect was evaluated after 4 weeks treatment in four groups. The level changes of total bilirubin( TBiL),alkaline phosphatase( ALP),total bile acid( TBA) and gamma glutamyl transferase( γ-GT) before and after treatment were compared in four groups. The long-term effects were observed by following up for 8 weeks. Results The total effective rate of damp-heat-stasis syndrome group was 88. 0%,the total effective rate of qi stagnation and blood stasis syndrome group was 52. 0%,the total effective rate of liver-depression and spleen-asthenia syndrome group was 52. 0%,the total effective rate of yin deficiency of liver kidney syndrome group was 48. 0%,the effect of damp heat stasis syndrome group was the best( P <0. 05). The levels of TBiL,ALP,TBA and γ-GT of liver function after treatment were significantly lower than those before treatment in four groups( P < 0. 05),and the levels of TBiL,ALP,TBA and γ-GT in damp-heat-stasis syndrome group were lower than those in the other three syndromes( P < 0. 05). There was no significant difference on TBiL,ALP,TBA and γ-GT at 8 weeks after treatment andthe end of treatment among the four groups( P > 0. 05). After 8 weeks treatment,the TBiL,ALP,TBA and γ-GT of liver function in damp-heat-stasis syndrome were lower than the other three syndromes( P < 0. 05). Conclusion Baihuang Ganning mixture combined with Ademetioni

关 键 词：黄疸 肝硬化 肝炎 乙型 辨证论治 中西医结合疗法 

分 类 号：R256.41[医药卫生—中医内科学] R575[医药卫生—中医学]