温肝通络法治疗乙肝肝硬化代偿期患者的临床效果  

Wengan Tongluo method for patients with compensated hepatitis B cirrhosis

作　　者：孔衍琳 赵晓丽[1] Kong Yanlin;Zhao Xiaoli(Department of Liver Diseases,Tai'an Traditional Chinese Medicine Hospital,Tai'an 271000,China)

机构地区：[1]泰安市中医医院肝病科,泰安271000

出　　处：《国际医药卫生导报》2025年第8期1332-1336,共5页International Medicine and Health Guidance News

基　　金：山东省中医药科技项目(M-2022075)。

摘　　要：目的探讨温肝通络法治疗乙肝肝硬化代偿期患者的临床效果。方法选取2022年8月至2024年7月泰安市中医医院收治的76例乙肝肝硬化代偿期患者进行随机对照试验。采用随机数字表法将其分为对照组和观察组,各38例。对照组年龄(40.61±4.98)岁,病程(5.61±1.46)年。观察组年龄(41.30±5.11)岁,病程(5.85±1.63)年。两组均行常规保肝、抗病毒治疗;对照组在此基础上添加吴茱萸温肝汤治疗,观察组在对照组的基础上添加脐部灸疗。比较两组中医证候积分、肝功能[天冬氨酸转氨酶(aspartate transaminase,AST)、丙氨酸转氨酶(alaninetransaminase,ALT)、白蛋白(albumin,ALB)、总胆红素(total bilirubin,TBil)]、肝硬化[肝硬度值(liver stiffness measurement,LSM)]及肝纤维化指标[血清层粘连蛋白(laminin,LN)、透明质酸(hyaluronicacid,HA)、Ⅳ型胶原(tpyeⅣcolagen,Ⅳ-C)、Ⅲ型前胶原(tpyeⅢprecollagen,PCⅢ)]。采用t检验、χ2检验进行统计分析。结果治疗后,两组腹胀、乏力、纳差、面色萎黄等中医证候积分均低于治疗前,且观察组均低于对照组(均P<0.05);两组AST、ALT、ALB、TBil水平均优于治疗前,且观察组均优于对照组(均P<0.05);两组LSM均低于治疗前,且观察组LSM低于对照组(P<0.05);两组LN、HA、Ⅳ-C、PCⅢ水平均低于治疗前,且观察组均低于对照组(均P<0.05)。对照组不良反应发生率为7.89%(3/38),观察组为2.63%(1/38),差异无统计学意义(校正χ2=0.264,P=0.607)。结论温肝通络法治疗乙肝肝硬化代偿期患者可以有效改善其中医证候、肝功能,并降低其肝硬度及肝纤维化程度,且安全性良好。Objective To explore the clinical effect of Wengan Tongluo method for patients with compensated hepatitis B cirrhosis.Methods Seventy-six patients with compensated hepatitis B cirrhosis treated at Tai'an Traditional Chinese Medicine Hospital from August 2022 to July 2024 were selected for the randomized controlled trial,and were divided into a control group and an observation group by the random number table method,with 38 cases in each group.The control group was(40.61±4.98)years old;the disease course was(5.61±1.46)years.The observation group was(41.30±5.11)years old;the disease course was(5.85±1.63)years.Both groups were treated with routine liver protection and antiviral therapy;the control group were treated with Wuzhuyu Wengan Decoction,and the observation group with Wuzhuyu Wengan Decoction and umbilical moxibustion.The scores of traditional Chinese medicine syndromes,liver function[aspartate transaminase(AST),alaninetransaminase(ALT),albumin(ALB),and total bilirubin(TBil)],cirrhosis[liver stiffness measurement(LSM)],and hepatic fibrosis indicators[serum laminin(LN),hyaluronicacid(HA),typeⅣcollagen(Ⅳ-C),and type III precollagen(PCⅢ)]were compared between the two groups.t andχ^(2) tests were used for the statistical analysis.Results After the treatment,the scores of abdominal distension,fatigue,poor appetite,and pale complexion were lower than those before the treatment in both groups,and the scores in the observation group were lower than those in the control group(all P<0.05);the levels of AST,ALT,ALB,and TBil were better those those before the treatment,and the levels in the observation group were better than those in the control group(all P<0.05);the LSM was lower than that before the treatment in both groups,and the LSM in the observation group was lower than that in the control group(P<0.05);the levels of LN,HA,Ⅳ-C,and PCⅢwere lower than those before the treatment,and the levels in the observation group were lower than those in the control group(all P<0.05).There was no statistical diff

关 键 词：肝硬化 络病理论 温肝通络法 肝功能 肝硬度 肝纤维化 

分 类 号：R259[医药卫生—中西医结合]