通络消癥汤加减辨治乙型肝炎肝硬化代偿期的临床研究

Clinical research of Tongluo Xiaozheng decoction in the treatment of decompensated liver cirrhosis

目的探讨通络消癥汤加减辨治乙型肝炎肝硬化代偿期临床效果,以期提高临床效果。方法 106例乙型肝炎肝硬化代偿期患者随机分成2组。对照组53例,采用拉米夫定100 mg,阿德福韦酯10 mg,恩替卡韦0.5 mg抗病毒治疗,以上剂量1次/d口服治疗。观察组在对照组基础上加用通络消癥汤加减治疗。2组患者均治疗6个月。观察治疗前后相关指标变化情况。结果对照组临床治愈率24.53%,总有效率79.24%,观察组临床治愈率39.62%、总有效率92.45%,2组比较差异有统计学意义(P<0.05);2组治疗后在LN、HA、IV-C、PCⅢ、脾脏厚度、门脉宽度上较治疗前比较均明显下降,治疗前后比较差异有统计学意义(P<0.05);观察组治疗后LN、HA、IV-C、PCⅢ、脾脏厚度、门脉宽度下降水平较对照组治疗后更加显著(P<0.05)。2组治疗后均无不良反应出现。结论通络消癥汤加减辨治联合常规抗病毒治疗,可有效改善乙型肝炎肝硬化代偿期患者肝纤维化指标及临床症状,达到标本兼治的临床效果。

Objective To explore the clinical effect of Tongluo Xiaozheng decoction in the treatment of decompensated hepatitis B cirrhosis, in order to improve the clinical effect. Methods 106 patients with hepatitis B cirrhosis were divided into two groups, the control group of 53 cases was treated by lamivudine 100mg, adefovir dipivoxil 10mg, entecavir 0.5mg antiviral therapy, the above dose 1/d oral treatment. The observation group was treated with Tongluo Xiaozheng decoction on the basis of the control group. Results The clinical curative rate of the control group was 24.53% and the total effective rate was 79.24%. The clinical cure rate and the total effective rate of the observation group were 39.62% and 92.45% respectively. There was significant difference between the two groups （P〈0.05）. In the second group, the LN, HA, IV-C, PC Ⅲ, spleen thickness and portal vein width were significantly decreased after treatment, and there was significant difference between before and after treatment （P〈 0.05）. The decrease of LN, HA, IV-C, PC Ⅲ, spleen thickness and portal vein width in the observation group was more significant than that in the control group （P〈0.05）. There were no adverse reactions after treatment. Conclusion Tongluo Xiaozheng decoction combined with traditional anti-virus can effectively improve the liver fibrosis indexes and clinical smptoms of patients with decompensated liver cirrhosis, and achieve the clinical effect of while the treatment of etiology and symptoms.