“化浊调肝健脾”法对乙型肝炎病毒相关性肝硬化指标影响的临床研究  

Clinical study on the effect of"clearing turbid regulating liver and invigorating spleen"method on indicators of hepatitis B virus liver cirrhosis

作　　者：苏春芝[1,3] 杨倩 张金丽[1,3] 孟宪鑫 张云凤[1,3] 苏飞 张桐[1] 张瑜 SU Chunzhi;YANG Qian;ZHANG Jinli;MENG Xianxin;ZHANG Yunfeng;SU Fei;ZHANG Tong;ZHANG Yu(Department of Hepatology,Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang,050011,China;Department of Second Department of Spleen and Stomach Diseases,Hebei Provincial Hospital of Traditional Chinese Medicine;Key Laboratory of Turbidity and Toxicity Syndrome in Hebei Province)

机构地区：[1]河北省中医院肝病科,石家庄050011 [2]河北省中医院脾胃病二科 [3]河北省浊毒证重点实验室

出　　处：《中国中西医结合消化杂志》2024年第2期115-119,共5页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：河北省中医药管理局中医药创新专项(No:223777124D)。

摘　　要：目的:观察化浊调肝健脾法治疗乙型肝炎病毒相关性肝硬化(HBV-LC)患者的临床疗效。方法:采用随机数表法将112例HBV-LC患者分为“化浊调肝”治疗组(治疗组)和对照组,每组各56例。对照组给予恩替卡韦分散片抗病毒治疗,治疗组在对照组的基础上加用化浊调肝健脾汤,2组均治疗3个月。治疗结束后,比较2组患者治疗前后的临床疗效、中医症状总积分、肝功能、血清肝纤维化四项、Fibrotouch肝脏硬度测量值及外周血炎症因子水平的变化。结果:治疗3个月结束后,治疗组临床疗效总有效率高于对照组,中医症状总积分低于对照组(P<0.05)。2组患者谷草转氨酶(AST)、谷丙转氨酶(ALT)、γ-谷氨酰基转移酶(GGT)、总胆红素(TBIL)、层粘连蛋白(LN)、透明质酸(HA)、Ⅲ型前胶原氨基端肽(PCⅢNP)、Ⅳ型胶原(C-Ⅳ)、肝脏弹性指数、IL-17A、IL-6水平在治疗后均下降,且治疗组各项指标低于对照组(P<0.05)。2组患者IL-10水平在治疗后升高,且治疗组高于对照组(P<0.05)。结论:以“化浊调肝健脾”法则治疗HBV-LC可获得更好的临床疗效,有效改善患者中医症状总积分、肝功能及肝纤维化指标,降低炎症因子水平,延缓肝硬化病情进展。Objective To observe the clinical efficacy of the method of resolving turbid,regulating liver and invigorating spleen in the treatment of hepatitis B virus liver cirrhosis(HBV-LC).Methods The random number table method was used to divide 112 cases of HBV-LC patients into the"removing turbidity and regulating liver"treatment group(referred to as the treatment group)and the control group,with 56 cases each.The control group was given antiviral treatment with entecavir dispersible tablets,while the treatment group received additional treatment with Huazhuo Tiaogan Jianpi Tang on the basis of the control group.Both groups were treated for three months.After treatment,the clinical efficacy,total score of TCM symptoms,liver function index,four serum items of liver fibrosis,Fibrotouch liver hardness,and the level of inflammatory factors in peripheral blood were compared between the two groups.Results After three months,the treatment group's clinical curative effect of total effective rate was higher than the control group,and TCM symptoms in the treatment group total score was lower than the control group(P<0.05).The levels of glutamic oxaloacetic transaminase(AST),glutamic pyruvic transaminase(ALT),gamma-glutamyltransferase(GGT),total bilirubin(TBIL),laminin(LN),hyaluronic acid(HA),typeⅢprocollagen amino terminal peptide(PCⅢNP),typeⅣcollagen(C-Ⅳ),liver elasticity index,interleukin 17A(IL-17A)and interleukin 6(IL-6)decreased after treatment in both groups(P<0.05).And all indicators of the treatment group were lower than those in the control group.Interleukin-10(IL-10)levels increased after treatment in both groups and were higher in the treatment group than in the control group.The differences were statistically significant(P<0.05).Conclusion The principle of"resolving turbid,regulating liver and invigorating spleen"in the treatment of HBV-related liver cirrhosis can obtain a better clinical effect,effectively improve the total score of TCM symptoms,liver function and liver fibrosis index,reduce the level of inf

关 键 词：乙型肝炎病毒相关性肝硬化 化浊调肝健脾 炎症因子 

分 类 号：R575.2[医药卫生—消化系统]