柴胡当归散加减联合穴位注射丹参注射液治疗乙肝肝纤维化临床观察  

Clinical observation on the treatment of liver fibrosis in hepatitis B with modified Chaihu Danggui powder combined with acupoint injection of Danshen injection

作　　者：孙素红 周晓玲[3] 李泽鹏 覃杏幸 孙东琪[1] 磨奕玲 黄华萍 SUN Suhong;ZHOU Xiaoling;LI Zepeng;QIN Xingxing;SUN Dongqi;MO Yiling;HUANG Huaping(Graduate School of Guangxi University of Traditional Chinese Medicine,Nanning 530001,China)

机构地区：[1]广西中医药大学研究生院,广西南宁530001 [2]广西科技大学第一附属医院,广西柳州545001 [3]柳州市中医医院,广西柳州545001

出　　处：《陕西中医》2024年第4期477-480,489,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(8216150339);广西壮族自治区柳州市科技计划项目(2023YRZ0102);广西中医药大学研究生教育创新计划项目(YCBXJ2022025)。

摘　　要：目的:观察柴胡当归散加减联合穴位注射丹参注射液治疗乙肝肝纤维化的临床疗效。方法:选取乙肝肝纤维化患者86例,采用随机数字表法分为两组,每组43例,对照组予恩替卡韦治疗,观察组在恩替卡韦的基础上予柴胡当归散加减配合穴位注射丹参注射液治疗。2周为1个疗程,两组均连续治疗12个疗程。对比两组疗效,于治疗前后观察两组中医症候积分、肝纤维化指标[透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PC-Ⅲ)、Ⅳ型胶原(Ⅳ-C)]、肝功能指标[总胆红素(TBIL)、谷丙转氨酶(ALT)、谷草转氨酶(AST)]及肝脏硬度(LSM)差异,记录并比较两组患者不良反应发生率。结果:治疗后,观察组总有效率为95.35%,较对照组的79.07%更高(P<0.05)。观察组胁肋胀痛、胸闷善太息、神疲乏力、性情急躁、脘腹痞闷、小便不利、大便溏薄症候积分低于对照组(均P<0.05)。观察组HA、LN、PC-Ⅲ、Ⅳ-C、TBIL、ALT、AST水平及LSM低于对照组(均P<0.05)。结论:采用柴胡当归散加减配合穴位注射丹参注射液治疗乙肝肝纤维化患者可提升疗效,显著改善患者肝纤维指标及肝功能,降低肝脏硬度。Objective:To observe the clinical effect of modified Chaihu Danggui powder combined with acupoint injection of Danshen injection in the treatment of liver fibrosis in hepatitis B.Methods:A total of 86 patients who were diagnosed with liver fibrosis in hepatitis B were selected.They were divided into two groups by the random number table method,with 43 cases in each group.Patients in the control group were treated with enticavir,while those in the observation group were treated with modified Chaihu Danggui powder combined with acupoint injection of Danshen injection on the basis of enticavir treatment.With two weeks as a course of treatment,both groups received 12 courses of treatment.Therapeutic effects in the two groups were compared.Differences in TCM syndrome scores,liver fibrosis indicators [hyaluronic acid(HA),laminin(LN),type Ⅲ procollagen(PC-Ⅲ) and type Ⅳ collagen(Ⅳ-C)],liver function indicators [total bilirubin(TBIL),alanine transaminase(ALT) and aspartate transaminase(AST)] and liver stiffness measurement(LSM) before and after treatment were observed.The incidence rates of adverse reactions were recorded.Results:After treatment,the total effective rate in the observation group(95.35%) was higher than that in the control group(79.07%)(P<0.05).The scores for swelling and pain in the ribs,chest tightness,fatigue and fatigue,irritability,abdominal distension,poor urination and thin sloppy stool in the observation group were lower than those in the control group(all P<0.05).The levels of HA,LN,PC-Ⅲ,Ⅳ-C,TBIL,ALT and AST,and LSM in the observation group were lower than those in the control group(all P<0.05).Conclusion:Chaihu Danggui powder combined with acupoint injection of Danshen injection in the treatment of hepatitis B liver fibrosis patients can improve the curative effect,significantly improve the liver fiber index,liver function,and reduce the liver hardness.

关 键 词：乙型病毒性肝炎 肝纤维化 柴胡当归散 丹参注射液 穴位注射 炎症反应 

分 类 号：R575[医药卫生—消化系统]