加味茵陈四逆汤治疗阳虚瘀毒型乙肝相关慢性肝衰竭30例  

Clinical effect of Jiawei Yinchen Sini decoction in treatment of hepatitis B-related chronic liver failure with Yang deficiency and stasis toxin:An analysis of 30 cases

作　　者：覃绿星 刘静 陈淋 韦宛华 齐建华 张海英 QIN Lyuxing;LIU Jing;CHEN Lin;WEI Wanhua;QI JIanhua;ZHANG Haiying(Liuzhou Traditional Chinese Medicine Hospital/Liuzhou Zhuang Medicine Hospital,Liuzhou 545001,Guangxi,China)

机构地区：[1]柳州市中医医院/柳州市壮医医院,广西柳州545001

出　　处：《湖南中医杂志》2024年第4期10-13,41,共5页Hunan Journal of Traditional Chinese Medicine

基　　金：广西中医药大学校级青年基金项目(2020QN021)。

摘　　要：目的:观察加味茵陈四逆汤治疗阳虚瘀毒型乙肝相关慢性肝衰竭(CLF)的临床疗效。方法:将60例阳虚瘀毒型乙肝相关CLF患者随机分为治疗组和对照组,每组各30例。对照组采用西医综合疗法治疗,治疗组在对照组的基础上采用加味茵陈四逆汤治疗,2组均治疗8周。比较2组治疗前后的肝功能[血清总胆红素(TBil)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、白蛋白(ALB)]、凝血功能[凝血酶原时间(PT)、凝血酶原活动度(PTA)]、终末期肝病模型(MELD)评分、中医证候积分、病死率,评定综合疗效。结果:总有效率治疗组为86.67%(26/30),优于对照组的73.33%(22/30),差异有统计学意义(P<0.05)。治疗组肝功能、凝血功能、MELD评分、中医证候积分改善情况均优于对照组,差异均有统计学意义(P<0.05或P<0.01)。病死率治疗组为10.00%(3/30),对照组为20.00%(6/30),差异无统计学意义(P>0.05)。结论:加味茵陈四逆汤可有效减轻阳虚瘀毒型乙肝相关CLF患者的临床症状,改善肝功能及凝血功能,降低病死率,值得临床推广应用。Objective:To investigate the clinical effect of Jiawei Yinchen Sini decoction in the treatment of hepatitis B-related chronic liver failure(CLF)with Yang deficiency and stasis toxin.Methods:A total of 60 patients with hepatitis B-related CLF with Yang deficiency and stasis toxin were randomly divided into treatment group and control group,with 30 patients in each group.The patients in the control group received comprehensive Western medicine internal treatment,and those in the treatment group received Jiawei Yinchen Sini decoction in addition to the treatment in the control group;the course of treatment was 8 weeks for both groups.The two groups were compared in terms of traditional liver function(serum total bilirubin,alanine aminotransferase,aspartate aminotransferase,and albumin),coagulation function(prothrombin time and prothrombin time activity),Model for End-Stage Liver Disease(MELD)score,Chinese medicine(TCM)syndrome score,and mortality rate,and overall response was evaluated.Results:The treatment group had a significantly better overall response rate than the control group[86.67%(26/30)vs 73.33%(22/30),P<0.05].Compared with the control group,the treatment group had significantly better improvements in liver function,coagulation function,and MELD score,TCM syndrome score(P<0.05 or P<0.01).There was no significant difference in mortality rate between the treatment group and the control group[10.00%(3/30)vs 20.00%(6/30),P>0.05].Conclusion:For patients with hepatitis B-related CLF with Yang deficiency and stasis toxin,Jiawei Yinchen Sini decoction can effectively alleviate clinical symptoms,improve liver function and coagulation function,and reduce mortality rate,and therefore,it holds promise for clinical application.

关 键 词：乙肝相关慢性肝衰竭 阳虚瘀毒型 加味茵陈四逆汤 

分 类 号：R259.753[医药卫生—中西医结合]