养肝解毒汤从浊毒论治慢性乙型肝炎随机平行对照研究

Yanggan Decoction on the Treatment of Chronic Hepatitis B Randomized Parallel Controlled Study it from Turbidity Toxin

[目的]观察养肝解毒汤从浊毒论治慢性乙型肝炎疗效。[方法]使用随机平行对照方法,将128例门诊患者按随机数字表法随机分为两组。对照组60例乙肝舒康胶囊,1600mg/次,3次/d;甘草酸二铵肠溶胶囊,150mg/次,3次/d。治疗组68例养肝解毒汤(黄芪15g,当归、白芍、赤芍各10g,牡丹皮、女贞子各15g,天花粉10g,决明子、金银花各15g,苦参、拳参、杏仁、橘红、秦艽各10g,甘草6g),1剂/d,水煎400mL,分2次服。湿热浊毒之邪较盛伴黄疸减黄芪,加栀子、大黄、茵陈、虎杖等;肝郁脾虚加柴胡、郁金、白术、茯苓;阳气虚陷加桂枝、升麻。两组均连续治疗30d为1疗程。观测临床症状、肝功能、HBeAg、HBV-DNA、肝区叩击痛、肝脾肿大、不良反应。随访180d观测临床症状、肝功能、HBeAg、HBV-DNA、肝区叩击痛、肝脾肿大、不良反应。[结果]治疗组基本治愈32例,有效3例,总有效率91.20%。对照组基本治愈13例,有效39例,无效8例,总有效率86.70%。治疗组疗效优于对照组(P<0.05)。随访180d治疗组优于对照组(P<0.05)。[结论]养肝解毒汤从浊毒论治慢性乙型肝炎效果显著,值得推广。

[ Objective ] To observe the curative effect of Yanggan Decoction on the treatment of chronic hepatitis B from turbidity toxin. [ Methods ] Using randomized controlled methods, 128 patients were randomly divided into two groups. A control group of 60 cases of Yiganshukang capsules, 1600mg/times, 3 times/d ; Diammonium Glycyrrhizinate Enteric-coated Capsules, 150mg/times, 3 times/d. The treatment group of 68 cases liver detoxification Decoction （ Radix Angelica sinensis, Radix Paeoniae Alba, Radix Paeoniae Rubra 15g, each lOg, tree peony bark, Ligustrum lucidum 15g, lOg trichosanthin, cassia seed, honeysuckle 15g, Sophora flavescens, bistort, almonds, dried tangerine peel, Gentiana lOg, licorice 6g）, 1 doses of/d, water simmer in water 400mL, cent is taken 2 times. Damp turbidity toxin evil is filled with jaundice reducing Astragalus, rhubarb, gardenia, with Yin Chen, giant knotweed rhizome;liver stagnation and spleen deficiency plus bupleurum, radix curcumae, Atractylodes, Poria cocos;Yang Qi Depression Guizhi, CiMicifuga foetida. The two groups were continuous treatment with 30d for 1 courses. Observation of clinical symptoms, liver function, HBeAg, HBV-DNA, liver area percussion pain, hepatosplenomegaly, adverse reaction. Follow up 180d observation of clinical symptoms, liver function, HBeAg, HBV-DNA, liver area percussion pain, hepatosplenomegaly, adverse reaction. [ Results ] The treatMent group cured 32 cases, effective in 3 cases, the total efficiency of 91.20%. The control group cured 13 cases, effective 39 cases, invalid 8 cases, the total efficiency of 86.70%. The treatMent group was better than control group （ P 〈 0.05 ） . The control group after 180d treatment group （ P 〈 0.05 ） . E Conclusion ] Yanggan decoction from turbidity toxin in the treatment of chronic hepatitis B effect is significant, worthy of promotion.