二术解毒汤治疗乙型肝炎肝硬化高甲胎蛋白血症临床疗效  

Preliminary study on the efficacy of Ershu Jiedu Decoction in the treatment of hepatitis B cirrhosis with Hyperalpha fetoproteinemia

作　　者：陈天阳[1] 奚骏 何胜利 傅益飞 张银华 龚亚华 薛建华 陈建杰[1] 成扬[1,2] CHEN Tian-yang;XI Jun;HE Sheng-li;CHENG Yang(Shuguang hospital affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;不详)

机构地区：[1]上海中医药大学附属曙光医院肝硬化科,上海201203 [2]上海浦东新区传染病医院 [3]复旦大学附属肿瘤医院闵行分院

出　　处：《中西医结合肝病杂志》2019年第6期497-499,共3页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：上海市科委科研项目(No.17401935000);上海市浦东新区卫计委“中医肝病学”重点学科建设项目(No.PWZxk2017-30);上海市浦东新区卫计委“中医肝病”临床中医特色学科建设项目(No.PDZY-2018-0607)

摘　　要：目的:探讨二术解毒汤治疗乙型肝炎肝硬化伴高甲胎蛋白血症的临床疗效。方法:将符合入组标准的72例乙型肝炎肝硬化伴高甲胎蛋白血症的患者随机分为治疗组和对照组,治疗组患者予以二术解毒汤颗粒剂治疗,对照组患者只予二术解毒汤安慰剂治疗。治疗48周后,观察两组患者治疗前后甲胎蛋白(AFP)、甲胎蛋白异质体(AFP-L3)、血清丙氨酸氨基转移酶(ALT)、天门氡氨酸氨基转移酶(AST)、总胆红素(TBil)、血清谷氨酰转肽酶(GGT)、血清白蛋白(Alb)的变化。结果:治疗组患者显效10例,有效16例,无效6例,有效率81.3%;对照组患者显效3例,有效9例,无效18例,有效率40.0%,两组有效率比较治疗组明显高于对照组(P<0.05);与对照组相比,治疗组患者AFP、AFP-L3水平明显降低,差异具有统计学意义(P<0.05);ALT、AST、GGT、TBil水平明显降低,Alb水平升高,患者肝功能显著改善,差异具有统计学意义(P<0.05)。结论:二术解毒汤对乙型肝炎肝硬化伴高甲胎蛋白血症的患者具有良好的临床疗效,值得进一步推广。Objective:To investigate the clinical efficacy of Ershu Jiedu Decoction in the treatment of hepatitis B cirrhosis with high alpha fetoproteinemia. Methods:Total of 62 patients with hepatitis B cirrhosis and high alpha fetoproteinemia who met the inclusion criteria were randomly divided into treatment group(n=36) and control group(n=36). The patients in the treatment group were treated with Ershu Jiedu Decoction Granules, and the patients in the control group were only treated with Ershu Jiedu decoction placebo. After48 weeks of treatment, the changes of AFP, AFP-L3, ALT, AST, TBIL, GGT, Alb were observed before and after treatment. Results:The final test was performed in 62 patients, 32 in the treatment group and 30 in the control group. The treatment group was markedly effective in 10 cases, effective in 16 cases, ineffective in 6 cases, with an effective rate of 81.3%, while the control group was markedly effective in 3 cases, effective in 9 cases, and ineffective in 18 cases. The effective rate was 40%. The effective rate of the treatment group was significantly higher than that of the control group(P<0.05).Compared with the control group, the treatment group can significantly reduce the levels of AFP and AFP-L3, the difference was statistically significant(P<0.05). Compared with the control group, the treatment group could significantly reduce the levels of ALT, AST, GGT and TBIL,Increase ALb levels,significantly improved liver function in patients, and the difference was statistically significant(P<0.05). Conclusion:Ershu Jiedu Decoction has a good clinical effect on patients with hepatitis B cirrhosis and high alpha fetoproteinemia, which is worth further promotion.

关 键 词：肝炎 乙型 肝硬化 二术解毒汤 甲胎蛋白 甲胎蛋白异质体 

分 类 号：R259[医药卫生—中西医结合]