茵陈五苓散治疗乙型肝炎肝硬化合并自发性细菌性腹膜炎临床研究  

Clinical Study on Five Substances Powder with Poria Plus Virgate Wormwood in Treating Hepatitis B Liver Cirrhosis Complicated with Spontaneous Bacterial Peritonitis

作　　者：章璐 ZHANG Lu(Zhuhai People's Hospital,Zhuhai Hospital Afriliated to Jinan University,Zhuhai,Guangdong,China,519000)

机构地区：[1]珠海市人民医院,暨南大学附属珠海医院,广东珠海519000

出　　处：《河南中医》2023年第1期11-15,共5页Henan Traditional Chinese Medicine

基　　金：广东省中医药管理局科研项目(20203008)。

摘　　要：目的:观察茵陈五苓散对乙型肝炎肝硬化合并自发性细菌性腹膜炎(spontaneous bacterial peritonitis, SBP)患者肝纤维化指标、细菌感染标记物及炎性因子的影响。方法:选取2017年6月至2020年5月珠海市人民医院收治的脾虚湿热型乙型肝炎肝硬化合并SBP患者80例,按照随机数字表法分为观察组与对照组,每组40例。对照组给予头孢噻肟治疗,观察组在对照组治疗的基础上给予茵陈五苓散治疗。观察两组患者治疗后肝纤维化指标Ⅲ型前胶原(procollagen type procollagen typeⅢ,PCⅢ)、血清Ⅳ型胶原(type IV collagen,Ⅳ-C)、层黏连蛋白(laminin, LN)和透明质酸(hyaluronic acid, HA),细菌感染标记物C反应蛋白(C reactive protein, CRP)、血清降钙素原(procalcitonin, PCT)以及炎性因子-α(tumor necrosis factor, TNF-α)、白细胞介素-6(interleukin, IL-6)变化情况。结果:两组治疗后PCⅢ、Ⅳ-C、LN和HA均低于本组治疗前,且观察组PCⅢ、Ⅳ-C、LN和HA低于对照组,差异有统计学意义(P<0.05);两组治疗后PCT、CRP均低于本组治疗前,且观察组治疗后PCT、CRP低于对照组,差异有统计学意义(P<0.05);两组治疗后TNF-α、IL-6均低于本组治疗前,且观察组治疗后TNF-α、IL-6低于对照组,差异有统计学意义(P<0.05);观察组临床症状改善时间均明显短于对照组,差异有统计学意义(P<0.05)。结论:茵陈五苓散可有效降低乙型肝炎肝硬化合并SBP患者肝纤维化指标、细菌感染标记物、炎性因子的含量,促进患者病情恢复。Objective: To observe the influence of Five Substances Powder with Poria Plus Virgate Wormwood on liver fibrosis indexes, bacterial infection markers and inflammatory factors in patients with hepatitis B cirrhosis complicated with spontaneous bacterial peritonitis(SBP).Methods: A total of 80 patients with liver cirrhosis complicated with SBP of spleen deficiency and dampness-heat hepatitis B admitted to Zhuhai People′s Hospital from June 2017 to May 2020 were selected and divided into the observation group and the control group according to random number table, with 40 cases in each group.The control group was treated with cefotaxime, while the observation group was treated with Five Substances Powder with Poria Plus Virgate Wormwood on the basis of the control group.After treatment, the changes the liver fibrosis indexes of the two groups such as procollagen type procollagen type Ⅲ(PCⅢ),type Ⅳ collagen(Ⅳ-C),laminin(LN),hyaluronic acid(HA),C reactive protein(CRP),procalcitonin(PCT),tumor necrosis factor-α(TNF-α) and interleukin(IL-6) were observed.Results: After treatment, PC Ⅲ,Ⅳ-C,LN and HA in the two groups were lower than those of the same group before treatment, and PC Ⅲ,Ⅳ-C,LN and HA in the observation group were lower than those in the control group, and all the differences were statistically significant(P<0.05).PCT and CRP in the two groups after treatment were lower than those of the same group before treatment, and PCT and CRP in the observation group were lower than those in the control group, and all the differences were statistically significant(P<0.05).After treatment, TNF-α and IL-6 in both groups were lower than those of the same group before treatment, and TNF-α and IL-6 in the observation group were significantly lower than those in the control group, and all the differences were statistically significant(P<0.05).The improvement time of adverse clinical symptoms in the observation group was significantly shorter than that in the control group and the difference was statistic

关 键 词：乙型肝炎 肝硬化 自发性细菌性腹膜炎 脾虚湿热证 茵陈五苓散 《金匮要略》 张仲景 

分 类 号：R259.752[医药卫生—中西医结合]