益气化浊解胀汤治疗乙肝肝硬化的临床疗效及对谷草转氨酶-血小板比值指数的影响

Clinical Efficacy of Yiqi Huazhuo Jiezhang Decoction in Treatment of Hepatitis B Cirrhosis and Its Effect on Ration Index of Glutamic Oxaloacetic Transaminase-Platelet

目的观察益气化浊解胀汤治疗乙肝肝硬化的临床疗效及对谷草转氨酶-血小板比值指数的影响。方法选择2017年1月-2019年1月医院收治的乙肝肝硬化患者160例,按照随机对照原则分为研究组和对照组,每组80例。对照组患者口服替诺福韦酯治疗,300 mg/d,1次/d。研究组在对照组治疗的基础上,口服益气化浊解胀汤治疗,两组患者均治疗24周。比较两组患者治疗前后中医症候积分、治疗疗效,治疗前后肝功能指标,肝纤维化指标APRI、TGF-β和LSM水平,比较治疗前后HBV-DNA含量。结果研究组治疗总有效率为91.25%(73/80)高于对照组治疗总有效率的80.00%(64/80)(P<0.05);研究组治疗后中医证候积分低于对照组(P<0.05);研究组治疗后肝功能指标ALT、AST、TBiL水平低于对照组,ALB水平高于对照组(P<0.05);研究组治疗后APRI和LSM水平低于对照组(P<0.05);研究组治疗后HBV-DNA和TGF-β水平低于对照组(P<0.05)。结论益气化浊解胀汤辅助治疗乙肝肝硬化疗效确切,可改善患者的临床症状,在控制病毒感染增殖情况的同时,延缓肝纤维化进程,促进肝功能恢复,提高治疗疗效,值得临床进一步研究探讨。

Objective To observe the clinical efficacy of Yiqi Huazhuo Jiezhang Decoction in the treatment of hepatitis B cirrhosis and its effect on the ratio index of glutamic oxaloacetic aminotransferase-platelet.Methods A total of 160 patients with hepatitis B cirrhosis admitted to our hospital from January 2017 to January 2019 were divided into study group and control group according to the principle of randomized control,80 cases in each group.The patients in the control group were treated with tenofovir dipivoxil orally,300 mg/d,once a day.On the basis of the treatment of the control group,the study group was treated with Yiqi Huazhuo Jiezhang Decoction.Both groups were treated for 24 weeks.The scores of TCM symptoms,therapeutic effects,liver function indexes,liver fibrosis indexesAPRI,TGF-beta and LSM before and after treatment were compared between the two groups.HBV-DNA content before and after treatment was compared.Results The total effective rate of the study group was 91.25%(73/80),higher than 80.00%(64/80)of the control group(P<0.05).The scores of TCM symptoms in the study group were lower than those in the control group(P<0.05).The levels of ALT,AST and TBIL in the study group were lower than those in the control group,and the levels of ALB in the study group were higher than those in the control group(P<0.05).After treatment,the levels of APRI and LSM were lower than those of the control group(P<0.05),while the levels of HBV-DNA and TGF-beta in the study group were lower than those in the control group(P<0.05).Conclusion Yiqi Huazhuo Jiezhang Decoction is effective in the adjuvant treatment of hepatitis B cirrhosis.It can improve the clinical symptoms,control the proliferation of viral infection,delay the process of hepatic fibrosis,promote the recovery of liver function and improve the therapeutic effect.It is worthy of further study and discussion in clinic.