芪苓益肝颗粒治疗正虚血瘀型肝硬化患者的效果观察

Efficacy observation of Qiling Yigan Granule in the treatment of patients with liver cirrhosis in the healthy qi deficiency and blood stasis pattern

目的评估芪苓益肝颗粒对正虚血瘀型肝硬化预后因素及生存质量的临床疗效。方法将符合肝硬化及中医正虚血瘀证诊断标准的200例患者分为对照组(90例)和治疗组(110例),两组分别给予一般护肝基础治疗,对照组依据辨证给予养肝健脾滋肾中药汤剂治疗,每日1剂,早晚分服,治疗组在辨证治疗基础上加服芪苓益肝颗粒,以中药煎剂冲服每日2次,每次30 g。疗程为6个月。两组于治疗前后分别进行Child-Pugh分级、中医证候积分和SF-36生存量表(包括90例健康人群)分值测定。结果疗程结束后Child-Pugh评分治疗组A、B、C级别所占比率较治疗前有改善,差异有统计学意义(P<0.05),与对照组比较差异亦有统计学意义(P<0.05)。中医证侯积分治疗结束两组患者均比治疗前下降,差异有统计学意义(P<0.05)。SF-36量表两组患者治疗前后总分及各维度分值明显低于健康人群,差异有统计学意义(P<0.05);疗程结束治疗组SF-36总分和生理功能、躯体疼痛、日常精力、精神健康分值较治疗前提高,差异有统计学意义(P<0.05);疗程结束治疗组的SF-36总分及生理功能、生理职能、社会功能分值较对照组增高,差异有统计学意义(P<0.05),在一般健康状况、日常精力、情感智能、精神健康方面分值较对照组增高但差异无统计学意义(P>0.05);对照组社会功能和精神健康较治疗前分值增高,差异有统计学意义(P<0.05)。疗程结束治疗组Child-Pugh评分、SF-36分值疗效与对照组比较明显改善,差异有统计学意义(P<0.05),中医证候积分疗效略高于对照组,差异无统计学意义(P>0.05)。结论芪苓益肝颗粒临床治疗肝硬化正虚血瘀证患者临床疗效肯定,通过影响和改善预后因素,可提高肝硬化患者生存质量。

Objective To evaluate the prognosis factors＇ and quality of life＇s clinical effects of Qiling Yigan Granule in the treatment of patients suffering from liver cirrhosis belonging to healthy qi deficiency and blood stasis pattern.Methods 200 liver cirrhosis patients meeting the diagnosis standard of healthy qi deficiency and blood stasis pattern in traditional Chi nese medicine（TCM） were divided into control group（90 cases） and treatment group（110 cases）.Except for the basic treat ment for liver protection in both groups,according to pattern identification and treatment,in the control group,the patients were treated with decoction with functions of nourishing the liver,fortifying the spleen,and enriching the kidneys（take in the morning and evening,one pack per day） while in the treatment group,they were given Qiling Yigan Granule（30 g each time,twice a day）.The course of the treatment was lasted for six months.Scores of Child-Pugh grading,TCM syndrome,and SF-36 life scale also applied to 90 healthy volunteer were calculated before and after the treatment in both groups.Results After treatment,in the aspect of Child-Pugh scoring,proportion of grade A,grade B,and grade C was improved compared with that of pre-treatment in the treatment group with a significant difference（P0.05）.Also,compared with the proportion in the control group,there was a statistical difference（P0.05）.TCM syndrome scores in both groups were both decreased compared with those of pre-treatment with a significant difference（P0.05）.Aggregate scores of SF-36 before and after treatment in the two groups and scores from every dimension were obviously lower than those of healthy volunteer with a statistical difference（P0.05）.After the course,compared with pre-treatment,SF-36 aggregate score and scores of physiological function,body pain,energy in daily life,and mental health were increased in the treatment group with a significant difference（P0.05）.After six months,compared with the control group,aggregate score of SF-36 and scores of physiological function,social function were improved in the treatment group with a statistical difference（P0.05）,while in the aspects of general state of health,energy in daily life,emotion and mental ability,and mental health,those scores in treatment group were higher compared with control group,but without statistical difference（P0.05）.In the control group,scores of social function and mental health were higher than those of pre-treatment with a significant dif ference（P0.05）.After the course,effects of Child-Pugh score and SF-36 score were remarkably improved compared with those of the control group with a great difference（P0.05）,and effect of TCM syndrome score in the treatment group was slightly higher than that of the control group without a statistical difference（P0.05）.Conclusion Qiling Yigan Granule＇s application to liver cirrhosis patients in healthy qi deficiency and blood stasis pattern obtains an affirmative clinical effect and can improve their quality of lives through influencing and bettering prognosis factors.