培土益肝汤联合复方鳖甲软肝片与水飞蓟宾治疗肝郁脾虚型代偿期酒精性肝硬化随机平行对照研究

Peitu Yigan Tang(培土益肝汤) Combined with Western Medicine Deficiency Decompensated Alcoholic Cirrhosis Randomized Controlled Study

[目的]观察培土益肝汤联合复方鳖甲软肝片与水飞蓟宾治疗肝郁脾虚型代偿期酒精性肝硬化疗效。[方法]使用随机平行对照方法,将72例住院及门诊患者按抛硬币法简单随机分为两组。对照组36例复方鳖甲软肝片,2g/次,3次/d;水飞蓟宾,70mg/次,3次/d。治疗组36例培土益肝汤(党参20g,郁金12g,白术20g,云苓30g,川楝子10g,麦芽、虎杖各20g,三棱、文术各10g,鳖甲炙、白芍各20g,赤芍15g,马鞭草20g,甘草6g;胁痛甚加元胡、田基黄;纳呆加内金、神曲;腹胀甚加枳壳、大腹皮;瘀滞甚加土元、山甲;阴虚加沙参、麦冬、生地;气虚加黄芪、黄精);1剂/d,水煎300m L,早晚口服;西药治疗同对照组。连续治疗6个月为1疗程。观测临床症状、谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷氨酰转肽酶(GGT)、总胆红素(TBIL)、不良反应。治疗1疗程,判定疗效。[结果]临床疗效治疗组疗效优于对照组(P<0.05)。肝功能指标治疗组改善优于对照组(P<0.05)。[结论]培土益肝汤联合复方鳖甲软肝片与水飞蓟宾治疗肝郁脾虚型代偿期酒精性肝硬化,疗效满意,无严重不良反应,值得推广。

[Objective] To observe the PTYGT combined with Western medicine liver and spleen deficiency decompensated alcoholic cirrhosis efficacy. [Methods] Random parallel control method, 72 patients hospitalized and outpatients by a coin toss method is simple randomized into two groups. The control group of 36 patients Fufangbiejiarangan tablets, 2 g/time, 3 times/d; silibinin, 70 mg/time, 3 times/d. Treatment group of 36 patients PTYGT （Dangshen 20 g, Yujin 12 g, Baizhu 20 g, Yunling 30 g, Chuanjiezi 10 g, Maiya, Huzhang each 20 g, Sanleng, Wenzhu each 10g, Biejia, Baishao 20 g, Chishao 15g, Mabiancao 20 g, Gancao 6; hypochondriac even the Canadian yuanhu, Tianjihuang; anorexia within plus Neijin, Shenqu; plus bloating very Zhike, Dafupi; stasis even add Tuyuan, Shanjia; Yin Gaza Shashen, Maidong,Shengdi; Qi huangqi, Huangjing）; l/d, decoction 300mL, sooner or later, oral, 150mL/times; western medicine with the control group. Continuous treatment for 6 months for a course of treatment. Observation of clinical symptoms, alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, glutamyl peptidase （GGT）, total bilirubin （TBIL）, adverse reactions. One course of treatment, to determine efficacy, [Results] Treatment group, 15 cases markedly effective in 18 cases, 3 cases, the total efficiency of 91.67%. Group 8 cases were markedly effective in 18 cases, 10 cases, the total efficiency 77.78%. Treatment group than the control group （P〈0.05）. Most groups have improved liver function （P〈0.05）, the control group ALT, AST no improvement after treatment （P〉0.05）, the treatment group than the control group improved （P〈0.05）. [Conclusion] Combined Western Medicine earth PTYGT and spleen deficiency satisfaction decompensated alcoholic cirrhosis efficacy, no serious adverse reactions, should be promoted.