清肝冲剂与补肾冲剂治疗慢性丙型肝炎疗效的对比研究

Comparative Study on Efficacy of Qinggan Granule and Bushen Granule in Treating Chronic Hepatitis C

目的 :从临床、生化、病理三方面评价清肝冲剂、补肾冲剂两方治疗慢性丙型肝炎 (丙肝 )的疗效 ,探讨中医治疗丙肝的治法治则。方法 :慢性丙肝患者 66例 ,其中清肝冲剂治疗组 (清肝组 ) 36例 ,补肾冲剂治疗组 (补肾组 ) 18例 ,两方均每次 30 g ,每日 3次 ,连服 6个月 ;空白对照组 12例。动态观察临床表现、生化指标 ,并比较治疗前后肝组织病理学变化。结果 :两方治疗后临床症状改善显著 ,均可使天冬氨酸转氨酶(AST)、丙氨酸转氨酶 (ALT)显著下降。清肝冲剂尚能升高白蛋白 ,降低碱性磷酸酶 (ALP)。对照组ALT无变化 ,AST继续升高。病理学观察表明 :清肝组 4 2 2 % (14 / 33例 )炎症分级下降 ,2 1 2 % (7/ 33例 )纤维化分期下降 ;补肾组 35 7% (5 / 14例 )炎症分级下降 ,2 1 4 % (3/ 14例 )纤维化分期下降 ;对照组 2 0 0 % (2 / 10例 )炎症分级下降 ,30 0 % (3/ 10例 )纤维化分期上升。半定量积分表明 :清肝组上述两项指标积分均显著下降 (P <0 0 5 ) ;补肾组只有炎症积分显著下降 ,对照组炎症积分轻度上升 ,纤维化积分显著上升 (P <0 0 5 )。结论 :清肝、补肾冲剂两方治疗后能显著改善症状 ,降低ALT、AST ,减轻肝内炎性损伤 ,减缓或逆转肝纤维化 ,且远期疗效稳定。清肝冲剂疗效相对优于补肾冲剂 ,提?

Objective: To evaluate the efficacy of Qinggan Granule (QGG) and Bushen Granule (BSG) in treating chronic hepatitis C (CHC) from blood donors clinically, biochemically and pathologically as well as to explore the therapeutical principle and methods of TCM. Methods: Sixty six patients with CHC were divided into three groups, the 36 patients in the QGG group treated with QGG, the 18 patients in the BSG group treated with BSG and the 12 patients in the control group untreated. The dose of QGG and BSG given was 30g each time, three times per day for 6 consecutive months. Clinical and serum biochemical parameters as well as pathological change of liver biopsy before and after treatment were observed dynamically and compared. Results: After treatment, in the two treated group, clinical symptoms were improved significantly, alanine transaminase (ALT) and aspartate aminotransferase (AST) reduced markedly. Moreover, QGG showed the effects of increasing albumin and lowering alkaline phosphatase (ALP). On the contrary, ALT still remained as before but AST further increased in the control group. Pathological examination showed that the inflammatory grade (IG) decreased in 42.2% and fibrotic stage (FS) decreased in 21.2% of the patients in the QGG group, but no significant changes of the two indexes occurred in the BSG group, while in the control group, IG unchanged and FS increased in 3 cases. Chevallier′s semi quantity system analysis showed significant decrease of both scores in the QGG group (P<0 05), only decrease of IG in the BSG group, and slight raise of IG and significant increase of FS (P<0 05) in the control group. Conclusion: Condition of chronic hepatitis C patient would deteriorate progressively if not treated in time, especially the development of fibrosis. QGG and BSG could improve the clinical symptoms significantly, lower ALT and AST, eliminate inflammatory damage in the liver, slow down or reverse liver fibrosis process with stable long term effect. Though most of the patients present a Syndrome of Liver Kidney Yin deficiency, the effect of QGG is superior to that of BSG, suggesting that the treatment of CHC should mainly be clearing principle, and method of clearing Liver and eliminating Dampness may be more suitable for them.