膈下逐瘀汤加减联合谷胱甘肽治疗乙型病毒性肝炎肝硬化患者的效果  

Effects of Gexia Zhuyu decoction combined with Glutathione in treatment of patients with hepatitis B cirrhosis

作　　者：周雪云 ZHOU Xueyun(Department of Digestive Traditional Chinese Medicine of Dehua County Hospital,Quanzhou 362500 Fujian,China)

机构地区：[1]德化县医院消化中医科,福建泉州362500

出　　处：《中国民康医学》2025年第8期123-125,133,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察膈下逐瘀汤加减联合谷胱甘肽治疗乙型病毒性肝炎(简称乙肝)肝硬化患者的效果。方法:选取2021年7月至2023年7月该院收治的68例乙肝肝硬化患者进行前瞻性研究,按照信封法将其分为对照组和研究组各34例。对照组采用谷胱甘肽治疗,研究组在对照组基础上联合膈下逐瘀汤加减治疗,比较两组临床疗效,治疗前后肝功能指标[丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)、天冬氨酸氨基转移酶(AST)、白蛋白(ALB)]水平、肝纤维化指标[Ⅳ型胶原(C-Ⅳ)、层粘连蛋白(LN)、透明质酸(HA)]水平、中医证候积分,以及不良反应发生率。结果:研究组治疗总有效率为88.24%(30/34),高于对照组的67.65%(23/34),差异有统计学意义(P<0.05);治疗后,研究组TBIL、ALT、AST水平均低于对照组,ALB水平高于对照组,差异有统计学意义(P<0.05);治疗后,研究组C-Ⅳ、LN、HA水平均低于对照组,差异有统计学意义(P<0.05);治疗后,研究组两胁刺痛、腹大且硬、肋下肿块等中医证候积分均低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:膈下逐瘀汤加减联合谷胱甘肽治疗乙肝肝硬化患者能提高治疗总有效率,改善肝功能指标水平,降低肝纤维化指标水平和中医证候积分,效果优于单纯谷胱甘肽治疗。Objective:To observe effects of Gexia Zhuyu decoction combined with Glutathione in treatment of patients with hepatitis B cirrhosis.Methods:A prospective study was conducted on 68 patients with hepatitis B cirrhosis admitted to this hospital from July 2021 to July 2023.According to the envelope method,they were divided into control group and study group,34 cases in each group.The control group was treated with Glutathione,while the study group was treated with Gexia Zhuyu decoction on the basis of that of the control group.The clinical efficacy,the levels of liver function indexes[alanine aminotransferase(ALT),total bilirubin(TBIL),aspartate aminotransferase(AST),albumin(ALB)]and liver fibrosis indexes[type IV collagen(C-IV),laminin(LN),hyaluronic acid(HA)],the Traditional Chinese Medicine(TCM)syndrome scores before and after the treatment,and incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the study group was 88.24%(30/34),which was higher than 67.65%(23/34)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of TBIL,ALT and AST in the study group were lower than those in the control group,the level of ALB was higher than that in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of C-IV,LN and HA in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the scores of TCM syndromes such as stabbing pain in both sides,large and hard abdomen,and subcostal mass in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Gexia Zhuyu decoction combined with Glutathione in the treatment of hepatitis B cirrhosis can improve the total effective rate of treatment,improve the levels of liver

关 键 词：膈下逐瘀汤加减 谷胱甘肽 乙型病毒性肝炎 肝硬化 肝纤维化 肝功能 中医证候积分 

分 类 号：R657.3[医药卫生—外科学]