参芪软肝汤配合抗病毒药物治疗肝硬化临床研究  

Shenqi Ruangan decoction combined with antiviral drugs in the treatment of liver cirrhosis

作　　者：谢旭 李国焕 贾文燕 张铭业 徐文婷 谭万芳 XIE Xu;LI Guohuan;JIA Wenyan;ZHANG Mingye;XU Wenting;TAN Wanfang(Infectious Diseases Department of Zhuhai Integrated Traditional Chinese and Western Medicine Hospital,Zhuhai 519000,China)

机构地区：[1]珠海市中西医结合医院感染性疾病科,广东珠海519000

出　　处：《陕西中医》2024年第6期771-774,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(82304927);广东省中医药局科研课题(20232161)。

摘　　要：目的:探索参芪软肝汤配合抗病毒药物防治肝硬化的临床疗效。方法:选取90例肝硬化患者,将其分为观察组和对照组各45例。对照组以常规抗病毒治疗,观察组增加参芪软肝汤治疗。评估对比两组患者的临床疗效、中医症候积分、肝功能指标、肝纤维化指标、肝组织病理变化、治疗安全性等指标。结果:观察组总有效率为91.11%,高于对照组的73.33%(P<0.05)。治疗后,观察组中医症候积分包括胁肋隐痛、倦怠乏力、口眼干涩、身目黄染评分均低于对照组(P<0.05)。观察组直接胆红素(DBIL)、谷丙转氨酶(ALT)、谷氨酰转移酶(GGT)、胆汁酸(TBA)低于对照组(P<0.05)。治疗后,观察组血清透明质酸(HA)、Ⅳ型胶原(Ⅳ-C)、Ⅲ型前胶原N端肽(PⅢPN-P)、层粘连蛋白(LN)水平低于对照组(P<0.05)。治疗后,观察组肝组织病理变化炎症分级、纤维化分期均优于对照组(P<0.05)。治疗期间两组不良反应发生率为15.56%、11.11%,两组比较差异无统计学意义(P>0.05)。结论:参芪软肝汤用于防治肝硬化效果较好,可减轻中医症候程度,降低肝功能及肝纤维化水平,改善肝组织病理状态,治疗安全性良好。Objective:To explore the clinical efficacy of Shenqi Ruangan decoction combined with antiviral drugs in prevention and treatment of cirrhosis.Methods:A total of 90 patients with cirrhosis were divided into observation group and control group,45 cases in each group.The control group was treated with conventional antiviral therapy,and the observation group was treated with Shenqi Ruangan decoction.The clinical efficacy,symptoms of traditional Chinese medicine,liver function indexes,liver fibrosis indexes,pathological changes of liver tissue,and treatment safety indexes of the two groups were evaluated and compared.Results:The total effective rate of observation group was 91.11%,which was higher than 73.33%in control group(P<0.05).After treatment,the scores of TCM symptoms in the observation group were lower than those in the control group(P<0.05),including dull pain in the hypochondrium,fatigue and fatigue,dry mouth and eyes,and yellow eye staining.Direct bilirubin(DBIL),alanine aminotransferase(ALT),glutamyltransferase(GGT)and bile acid(TBA)in observation group were lower than those in control group(P<0.05).After treatment,the serum levels of HA,Ⅳ-C,PⅢPN-P and LN in observation group were lower than those in control group(P<0.05).After treatment,the pathological changes of liver tissue inflammation grade and fibrosis stage in the observation group were better than those in the control group(P<0.05).The incidence of adverse reactions between the two groups was 15.56%and 11.11%,and there was no significant difference between the two groups(P>0.05).Conclusion:Shenqi Ruangan decoction is effective in preventing and treating liver cirrhosis.It can reduce the symptoms of traditional Chinese medicine,reduce liver function and liver fibrosis,and improve the pathological status of liver tissue.

关 键 词：肝硬化 参芪软肝汤 富马酸丙酚替诺福韦片 肝功能 中医症候 肝纤维化 

分 类 号：R575.2[医药卫生—消化系统]