清下消补方加减治疗乙型肝炎肝硬化合并高免疫球蛋白血症临床观察

Clinical Observation of Qingxia Xiaobu Formula in Treatment of Posthepatitis B Cirrhosis with Hyperimmunoglobulinemia

目的:观察清下消补方治疗乙型肝炎肝硬化合并高免疫球蛋白血症的临床疗效。方法:将81例患者随机分为2组,治疗组41例予杨氏清下消补方加减治疗;对照组40例予强肝胶囊治疗。2组均予相同西药保肝退黄常规治疗,包括支持疗法及对症处理。观察2组治疗前后临床症状、体征变化及血中谷丙转氨酶(ALT)、白蛋白(Alb)、球蛋白(Glb)、总胆红素(TBi)l、凝血酶原时间(PT)、γ-球蛋白含量,B超检查肝门静脉宽度及脾脏厚径。结果:2组治疗后ALT、Alb、Glb、TBil、PT、γ-球蛋白含量水平、肝门静脉宽度、脾脏厚径等指标均较治疗前明显改善(P<0.01);治疗组各项指标改善均优于对照组(P<0.05)。总有效率治疗组为82.93%,对照组为57.50%,2组比较,差异有显著性意义(P<0.05)。结论:清下消补方加减对乙型肝炎肝硬化合并高免疫球蛋白血症患者具有改善肝功能、降低球蛋白的效果。

Objective： To observe the clinical effect of Qingxia Xiaobu Formula for the treatment of pos- thepatitis B cirrhosis with hyperimmunoglobulinemia. Methods： Eighty-one cases of posthepatitis cirrhosis with hyperimmunoglobulinemia were divided into treatment group（41 cases） and control group（40 cases）. Both groups were given routine western medicine for preventing liver function and subsiding jaundice, and supporting and expectant treatment. Additionally, the treatment group was administered Qingxia Xiaobu Formula, and the control group was treated with Qianggan Capsules. The changes of symptoms and signs, and indexes such as alanine aminotransferase （ALT）, albumin （AIb）, immunoglobulin （GIb）, total bilirubin（TBil）, prothrombin time（PT）, γ-globulin, hepatic portal vein width and the thickness of the spleen showed by type B ultrasonography were observed. Results： All of the observation indexes in the two groups were improved significantly after treatment（P 〈 0.01）, and the improvement in the treatment group was superior to that in the control group, the difference being statistically significant（P 〈 0.05）. The total effective rate was 82.93% in the treatment group and 57.50% in the control group, showing statisti- cal difference（P 〈 0.05）. Conclusion： Qingxia Xiaobu Formula is effective on relieving the clinical symptoms, improving the hepatic function, and decreasing the immunoglobulin level of the posthepatitis cirrhosis with hyperimmunoglobulinemia.