针灸联合疏肝化瘀方治疗慢性乙型重型肝炎的效果观察  

Efficacy observation of acupuncture plus Shu Gan Hua Yu formula for chronic severe hepatitis B

作　　者：赵亚博 万贵香 梁微微 杜辉[1] 宁振海 周媛 万亮 ZHAO Yabo;WAN Guixiang;LIANG Weiwei;DU Hui;NING Zhenhai;ZHOU Yuan;WAN Liang(Hebei Handan Infectious Disease Hospital,Handan 056000,China)

机构地区：[1]河北省邯郸市传染病医院,邯郸056000

出　　处：《上海针灸杂志》2024年第9期999-1004,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：河北省中医药管理局科研计划项目(2022665)。

摘　　要：目的探讨针刺联合疏肝化瘀方在慢性乙型重型肝炎(chronic severe hepatitis B,CSHB)治疗中的应用价值。方法选取100例慢性乙型重型肝炎患者,随机分为西医组、针刺组、中药组和联合组,每组25例。西医组予以常规西医治疗,于此基础上,针刺组予以针刺治疗,中药组予以疏肝化瘀方,联合组予以针刺联合疏肝化瘀方治疗。观察4组临床疗效与安全性,比较4组治疗前、治疗1个月后、治疗6个月后中医症候积分、肝功能指标[谷丙转氨酶(alanine aminotransferase,ALT)、谷草转氨酶(aspartate aminotransferase,AST)及γ-谷氨酰转肽酶(γ-glutamyl transpeptidase,GGT)]和T淋巴细胞亚群(CD^(4+)、CD^(8﹢)和CD^(4+)/CD^(8﹢))。结果联合组、中药组及针刺组总有效率均高于西医组(P<0.05);治疗1个月、6个月后,联合组、中药组及针刺组中医证候主症、次症积分及总积分低于西医组(P<0.05);治疗1个月、6个月后联合组ALT、AST、GGT水平及CD^(8﹢)低于中药组、针刺组和西医组,CD^(4+)及CD^(4+)/CD^(8﹢)高于中药组、针刺组、西医组(P<0.05);4组治疗期间均未出现不良反应。结论在西医常规治疗基础上,针刺联合疏肝化瘀方联合治疗CSHB可提高疗效,改善免疫功能与肝功能,缓解患者症状,且具有较高安全性。Objective To discuss the application value of acupuncture-moxibustion plus Shu Gan Hua Yu formula in the treatment of chronic severe hepatitis B(CSHB).Method One hundred CSHB patients were selected and randomized into a Western medicine group,an acupuncture group,a Chinese medication group,and a combined group,each consisting of 25 cases.The Western medicine group was offered conventional Western medicine treatment,based on which the acupuncture group received acupuncture,the Chinese medication group received Shu Gan Hua Yu formula,and the combined group received both acupuncture and Shu Gan Hua Yu formula.The clinical efficacy and safety were observed in the four groups.The symptom scores of traditional Chinese medicine,liver function indicators[alanine aminotransferase(ALT),aspartate aminotransferase(AST),andγ-glutamyl transpeptidase(GGT)],and T-lymphocyte subsets(CD^(4+),CD^(8﹢),and CD^(4+)/CD^(8﹢))were compared before treatment and after 1-month and 6-month treatment.Result The combined group,Chinese medication group,and acupuncture group all surpassed the Western medicine group in comparing the total effective rate(P<0.05).After 1-month and 6-month treatment,respectively,the TCM primary symptom score,secondary symptom score,and total score were lower in the combined group,Chinese medication group,and acupuncture group than in the Western medicine group(P<0.05);the levels of ALT,AST,GGT,and CD^(8﹢)were lower in the combined group than in the Chinese medication group,acupuncture group,and Western medicine group,and the levels of CD^(4+)and CD^(4+)/CD^(8﹢)were higher in the acupuncture group than in the other three groups(P<0.05).None of the four groups showed adverse reactions during the treatment.Conclusion Based on conventional Western medicine treatment,acupuncture plus Shu Gan Hua Yu formula can enhance therapeutic efficacy in treating CSHB.This method can improve immune function and liver function and mitigate symptoms,showing high safety.

关 键 词：针刺疗法 乙型肝炎 慢性 肝功能 T淋巴细胞亚群 针药并用 

分 类 号：R246.1[医药卫生—针灸推拿学]