中医参芪归甲汤治疗血吸虫病的效果观察

Treatment Effect of Schistosomiasis Using Chinese Traditional Medicine Ginseng-Astragalus-Angelica-Turtle Shell Decoction

目的观察参芪归甲汤治疗血吸虫病的效果。方法选取2011-2012年血吸虫病现场防治中发现的血吸虫病患者,按同时使用吡喹酮杀虫和中医治疗的患者列为实验组,只进行吡喹酮杀虫的患者列为对照组。于治疗后1、3月跟踪随访。比较2组患者治疗后的病情改变,并比较实验组治疗前后的病情改变。结果实验组24例,其中白蛋白/球蛋白比值倒置者8例。治疗3月后,总蛋白、白蛋白、球蛋白和总胆红素均值分别比治疗前增加6.7 g/L、9.5 g/L、-2.8 g/L和-4.4μmol/L,白蛋白/球蛋白比值倒置者1例。对照组6例中,白蛋白/球蛋白比值倒置者2例。治疗3月后,总蛋白、白蛋白、球蛋白和总胆红素均值分别比治疗前增加1.8 g/L、-5.1 g/L、3.3 g/L和1.0μmol/L,白蛋白/球蛋白比值倒置者未见改变。参芪归甲汤治疗24例血吸虫病,疗后1月,症状明显改善和改善15例,总有效率为62.50%;肝功能改善16例,改善率66.67%;疗后3月,显效和有效21例,总有效率为87.50%;肝功能改善20例,改善率83.33%;各期症状体征变化例数其差异有统计学意义(!2=2.94,P<0.05),各期肝功能变化例数其差异有统计学意义(!2=3.64,P<0.05)。结论单纯性吡喹酮杀虫对血吸虫病患者疗效较差,用吡喹酮杀虫结合参芪归甲汤基础方治疗血吸虫病患者,能有效地保护并改善肝脏功能,减轻血吸虫病症状,阻止血吸虫病程的发展,效果显著。

Objective To observe the efficacy of ginseng - astragalus - angelica - turtle shell decoction （GAATD） in treatment of schistosomiasis. Methods Schistosomiasis patients reported in the control and pre- vention of Schistosomiasis in 2011 to 2012 were recruited. The patients were divided into an experimental group （with both praziquantel and accepting GAATD therapy） and a control group （with praziquantel only）. One month and three month after the treatment, the state of the illness were observed and compared in both groups, and the illness state was compared as well before and after treatment in the experimental group. Re- suits There were 24 cases in the experimental group, including 8 cases with Alb/G ratio inversions. The av- erages of TP, Alb, G and STB increased respectively 6. 7 g/L, 9.5 g/L, - 2. 8 g/L and - 4. 4μmol/L 3 months after treatment, with one case with Alb/G ratio inversion remained. There were 6 cases in the control group, including 2 cases with Alb/G ratio inversions. The averages of TP, Alb, G and STB increased re- spectively 1.8 g/L, -5.1 g/, 3.3 g/L and 1.0μmol/L 3 months after treatment, and 2 cases with Alb/G ratio inversions were found no changes. Among the 24 cases of schistosomiasis patients with GAATD therapy, the symptoms of 15 patients improved significantly or mildly, with the effective rate 62. 50%; 16 patients showed improvement in liver function （66.67%） ; at three month follow - up, the symptoms of 21 patients improved significantly or mildly, with a total effective rate 87.50% ; 20 patients （ 83.33% ） showed im- provement in liver function. There was a statistically difference in the changes of symptoms and signs in all periods （ Z 2 = 2. 94, P 〈 0. 05 ）, and a statistical difference was also observed in liver function change in all periods （ Z 2 = 3.64, P 〈 0. 05 ）. Conclusion A poor therapeutic effect is observed by simply taking praziqu- antel. Joint therapy with praziquantel and GAATD could significantly relieve the symptoms of schistosomiasis and restore the liver function as well as could prevent development course of this illness.