辨证治疗自身免疫性肝炎随机平行对照研究

Differential Treatment of Autoimmune Hepatitis Parallel Randomized Controlled Study

[目的]观察辨证治疗自身免疫性肝炎疗效。[方法]使用随机平行对照方法,将60例住院及门诊患者按就诊顺序编号简单随机分为两组。对照组30例甘草酸二铵胶囊,150mg/次,3次/d,口服;胆红素升高加茵栀黄颗粒,6g/次,3次/d,口服。治疗组30例①湿热蕴结,清利湿热方(薏苡仁、茵陈各30g,山药15g,黄荟、防风、五味子、白术、山栀炒、白芍各10g,甘草、大黄各8g,柴胡6g;阳黄身热加茵陈蒿12g,栀子、大黄各9g);②气滞血瘀,舒肝理气通补方(香附、陈皮、枳实、防风、赤白芍、茵陈、五味子、丹参各10g,甘草8g,川芎、鳖甲粉、柴胡各6g;血虚、血瘀加熟地、当归各15g,白芍10g,桃仁9g,红花6g);③肝肾阴虚,补肾固精方(郁金、茵陈、当归、麦冬、白芍、防风、沙参、生地、川楝子、五味子、郁金各10g,甘草8g);④肝郁脾虚,健脾疏肝方(扁豆、山药各15g,防风、茯苓、郁金、当归、茵陈、白芍、五味子、白术各10g,甘草8g,柴胡6g;头痛目眩,口燥咽干加生姜15g,薄荷、甘草炙各6g);上方均1剂/d,水煎400mL,早晚口服。连续治疗90d为1疗程。观测临床症状、中医症候积分、肝功能指标、不良反应。连续治疗3疗程,判定疗效。[结果]治疗组显效15例,有效9例,无效6例,总有效率80.00%。对照组显效6例,有效12例,无效12例,总有效率60.00%。治疗组疗效优于对照组(P<0.05)。中医症候积分改善治疗组优于对照组(P<0.05)。肝功能指标两组均有改善(P<0.05),治疗组改善优于对照组(P<0.05)。[结论]辨证治疗自身免疫性肝炎效果显著,值得推广。

[ Objective ] To observe the efficacy of dialectical treatment of autoimmune hepatitis. [ Methods] Random parallel control method, 60 cases of inpatient and outpatient treatment order numbers were divided into two groups. The control group 30 cases of glycyrrhizin diammonium capsules, 150mg / time, 3 times / d, orally;hilirubin plus Yinzhihuang particles, 6g / time, 3 times / d, orally. Treatment group of 30 patients （1） heat Accumulation, clearing heat side （Yiyiren, Yichen 30g, Shanyao 15g, Huanghui, Fanfeng, Wuweizi, Baizhu, Shanzhi fried, Baishao 10g, Gancao, Dahuang each 8g, Chaihu 6g;sun yellow fever plus Yinchenhaol2g, Zhizi, Dahuang9g ） ; （2）blood stasis, liver qi up side （ Xiangfu, Chenpi, Jishi, Fanfeng, Chibaishao, Wuweizi, Danshen each lOg, Gancao 8g, Xhuanxiong, Biejiafen, Chaihu each 6g;deficiency, blood stasis plus Shudi, Dangui 15g, Baishao 10g, Taoren 9g, Honghua 6g ） ; （3） liver and kidney, Bushengubiao Jing Fang （Yujin, Yinchen, Dangui, Maidong, Baishao, Fanfeng, Shashen, Shengdi, Chuanlianzi, Wuweizi, Yujin each 10g, Gancao 8g ）; （4） liver spleen, liver and spleen Fang （ Biandou, Shanyao each 15g, Fanfeng, Fuling, Yujin, Dangui, Yinchrn, Baishao, Wuweizi, Baizhu each 10g, Ganeao 8g, Chaihu 6g;headache, dizziness, dry mouth and throat add Shengjiang 15g, Bohe, Gancao fried each 6g ） . The above herbs are 1 / d, decoction 400mL, sooner or later orally. 90d is a continuous course of treatment. Observation of clinical symptoms, symptom scores, liver function, adverse reactions. Continuous treatment for 3 courses, 1o determine efficacy. [ Results ] 15 cases markedly effective in 9 cases, 6 cases, the total efficiency of 80.00%. The control group that were 6 cases, effective in 12 cases, 12 cases, the total efficiency 60.00%. Treatment group than the control group （ P〈0.05 ） . Symptom scores in treatment group than the control group （ P〈0.05 ） .Liver function improvement in the treatment group （ P〈0.05 ）, improvement in the treatment group than the control group （ P〈0.05 ） . [ Conclusion ] Differential Treatment of autoimmune hepatitis effect is significant, it is worth promoting.