摘要
目的分析黄芪附子汤加减辅助治疗脾肾阳虚型乙肝肝硬化的临床疗效。方法回顾性分析97例脾肾阳虚型乙肝肝硬化患者的临床资料,依据治疗方法的不同分为对照组与观察组。对照组50例行抗病毒、保肝、利尿剂、β受体阻滞剂等常规治疗,观察组47例在常规治疗基础上联合黄芪附子汤加减治疗。2组治疗6个月后评估疗效及不良反应,比较2组治疗前后的中医证候积分和血清肝功能指标丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBIL),HBV DNA定量,肝纤维化指标透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(CⅣ)、肝脏硬度值(LSM)。结果观察组临床疗效结果总有效率(95.74%,45/47)显著高于对照组(82.00%,41/50)(P<0.05)。治疗后,观察组中医证候积分、ALT、AST、TBIL、HBV DNA定量、HA、PCⅢ、CⅣ、LSM水平均低于对照组(P<0.05)。对照组不良反应总发生率(12.00%,6/50)与观察组(14.89%,7/47)比较,差异无统计学意义(P>0.05)。结论黄芪附子汤加减辅助治疗脾肾阳虚型乙肝肝硬化患者,可显著提高治疗效果,改善肝功能及肝纤维化指标,且安全性良好。
Objective To analyze the clinical efficacy of modified Huangqi Fuzi Decoction in the adjuvant treatment of hepatitis B cirrhosis with the syndrome of yang deficiency of the spleen and kidney.Methods The clinical data of 97 cases of hepatitis B cirrhosis with the syndrome of yang deficiency of the spleen and kidney treated from January 2021 to December 2023 were retrospectively analyzed.According to different treatment methods,they were divided into 2 groups.In the control group,50 patients received a routine treatment such as antiviral,liver protection,diuretics andβ-blockers.On the basis of conventional treatment,47 cases in the observation group were additionally treated with modified Huangqi Fuzi Decoction.After 6 months of treatment,the efficacy and adverse reactions of the two groups were evaluated,and the TCM syndrome scores,levels of serum liver function indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL)],HBV DNA quantification,liver fibrosis indexes[hyaluronic acid(HA),typeⅢprocollagen(PCⅢ),typeⅣcollagen(CⅣ),liver stiffness measurement(LSM)]were compared before and after treatment.Results The total effective rate in the observation group(95.74%,45/47)was significantly higher than that in the control group(82.00%,41/50)(P<0.05).After treatment,the TCM scores,ALT,AST,TBIL,HBV DNA quantification,levels of HA,PCⅢ,CⅣ,and LSM were all lower in the observation group than those in the control group(P<0.05).The total incidence of adverse reactions in the control group(12.00%,6/50)was not signifi cantly different from that in the observation group(14.89%,7/47)(P>0.05).Conclusion In the adjuvant treatment of hepatitis B cirrhosis patients with the syndrome of yang deficiency of the spleen and kidney,modified Huangqi Fuzi Decoction can significantly improve the therapeutic effect,improve liver function and liver fibrosis indexes,having good safety.
作者
张健荣
施亚军
姜伟杰
王忠成
ZHANG Jianrong;SHI Yajun;JIANG Weijie;WANG Zhongcheng(Department of Hepatology of Integrated Traditional and Western Medicine,Nantong Third Hospital Affiliated to Nantong University/Nantong Third People's Hospital,Nantong 226006,China)
出处
《吉林中医药》
2025年第9期1055-1058,共4页
Jilin Journal of Chinese Medicine
基金
江苏省中医药科技发展计划项目(MS2022093)。
关键词
黄芪附子汤加减
脾肾阳虚证
乙肝肝硬化
modified Huangqi Fuzi Decoction
syndrome of yang deficiency of spleen and kidney
hepatitis B cirrhosis
