退高黄汤治疗戊型肝炎(瘀热互结证)的临床观察  

Clinical Study of Tuigaohuang Decoction in the Treatment of Hepatitis E(Syndrome of Intermingled Phlegm and Blood Stasis)

作　　者：姚超 俞冲[1] 朱琦琦 Yao Chao;Yu Chong;Zhu Qiqi(Nantong Integrated Traditional Chinese and Western Medicine Clinical Medical College of Nanjing University of Traditional Chinese Medicine,The Third People′s Hospital of Nantong,Jiangsu,Nantong 226000,China)

机构地区：[1]南京中医药大学南通中西医结合临床医学院,江苏省南通市第三人民医院,江苏南通226000

出　　处：《中国中医急症》2025年第2期314-317,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：江苏省中医药管理局科技发展计划项目(MS2023115);南通市卫生健康委科研课题(QNZ2022037)。

摘　　要：目的 观察退高黄汤治疗戊型肝炎(瘀热互结证)患者的临床疗效及对淋巴细胞亚群的影响。方法将戊型肝炎患者72例随机分为治疗组与对照组各36例。治疗组在综合内科治疗基础上加用退高黄汤,对照组在综合治疗基础上加用安慰剂。比较两组患者治疗前后相关指标。结果 与对照组相比,治疗组总胆红素(TBil)下降更明显,前白蛋白(PA)升高显著,CD4、CD4/CD8升高明显;门静脉主干内径缩小、血流量和血流速度增加更为显著;包括透明质酸(HA)、Ⅲ型胶原(PⅢP)、Ⅳ型胶原(PⅣP)、层黏蛋白(LN)、肝脏硬度值(LSM)下降更为明显;总显效率及总症状积分改善均优于对照组(均P <0.05)。两组在治疗期间相关安全性指标正常。结论 退高黄汤可有效地降低戊型肝炎患者TBil水平,并调节细胞免疫功能,在抑制肝脏炎症发展方面具有良好效果,可改善肝脏微循环、阻断纤维化进展,具有广泛应用价值。Objective:To observe the clinical efficacy of Tuigaohuang Decoction in treating patients with Hepa-titis E(syndrome of intermin-gled phlegm and blood stasis)and its impact on lymphocyte subsets.Methods:72 patients diagnosed with Hepatitis E were selected and randomly divided into a treatment group and a control group,each with 36 cases.The treatment group received Tuigaohuang Decoction in addition to comprehensive in-ternal medicine treatment,while the control group received placebo alongside comprehensive treatment,Relevant indicators were compared between the two groups before and after treatment.Results:Compared with the control group,the treatment group showed more significant decreases in total bilirubin(TBil),increases in prealbumin(PA),CD4,and CD4/CD8 ratios;greater reductions in the main portal vein diameter,and more significant increas-es in blood flow volume and velocity;more significant decreases in hyaluronic acid(HA),type II collagen(PII P),type IV collagen(PIVP),laminin(LN),and liver stifness measurement(LSM);and better overll efficacy rates and improvements in total symptom scores(all P<0.05).Safety indicators remained normal during the treatment period for both groups.Conclusion:Tuigaohuang Decoction effectively reduces total bilirubin levels in patients with Hep-atitis E,regulates cellular immune function,shows good effects in inhibiting liver inflammation development,im-proves hepatic microcirculation,and blocks fibrosis progression,which has broad application value.

关 键 词：戊型肝炎 退高黄汤 中医药 瘀热互结证 

分 类 号：R512.6[医药卫生—内科学]