茵陈蒿汤合生脉散治疗慢性乙型重型肝炎的临床研究

Clinical Research on Yinchenhao Decoction and Shengmai Powder in Treating Chronic Severe Hepatitis B

目的观察茵陈蒿汤合生脉散治疗慢性乙型重型肝炎的临床疗效。方法采用随机对照研究方法,观察西医内科综合治疗对照组(n=37例)和加用茵陈蒿汤合生脉散结合治疗组(35例)共72例早中期慢性乙型重型肝炎患者的生化指标、凝血功能等疗效指标并比较两组疗效。结果经4周治疗,两组在治疗第1周时血清ALT、AST、TBIL、PTA、NH3水平均开始明显好转,至随访8周时接近正常水平,差异有统计学意义(P<0.05),且治疗组ALT在治疗第4周及随访第4周、AST在治疗第1、3周、TBIL及ET在治疗第4周及随访第4、8周、PTA在治疗第4周及随访第4周时,明显优于对照组,差异有统计学意义(P<0.05)。在综合疗效评价方面,两组间疗效差异无统计学意义(P>0.05)。结论在西医治疗慢性乙型重型肝炎的基础上,通过辨证论治联合运用茵陈蒿汤合生脉散加味中药治疗,可以明显改善早中期慢性乙型重型肝炎患者的生化指标,提高临床疗效。

Objective To investigate the clinical effect of Yinchenhao decoction and Shengmai powder in treating chronic severe hepatitis B. Methods 72 Patients of chronic severe hepatitis B were randomly divided into control group of 37 cases and treatment group of 35 cases.The control group received comprehensive treatment of Western medicine.The treatment group used Yinchenhao decoction and Shengmai powder on the basis of the control group.The changes of the function of the liver and hemoglutination were observed before and after the treatment, and the clinical effect was compared.Results Comparing the result of 4 weeks’ treatment, ALT, AST, TBIL, PTA and NH3 improved at the end of the 1st week, while they were closed to normal at 8th weeks, and the difference was statistically significant （P〈0.05）.The improvement of ALT in 4st week followed up, AST in 1st and 3rd weeks treatment, TBIL and ET in 4th week treatment and 4th and 8th weeks followed up of the treatment group were significantly better than that of the control group, and the difference was statistically significant （ P〈0.05 ） .The difference of comprehensive therapeutic effect between the two groups had no statistically significant （P〈0.05）.Conclusion The treatment based on syndrome differentiation combined with Yinchenhao decoction and Shengmai powder on the basis of the Western medicine in treating chronic severe hepatitis B was effective.It can improve the biochemical indexes and clinical therapeutic effect.