地耳草免煎颗粒联合耳穴压豆治疗肝胆湿热型急性淤胆型肝炎临床观察

Clinical observation on the treatment of acute cholestasis hepatitis of damp-heat type of liver and gallbladder with Diercao Mianjian Granule combined with auricular point pressing

目的探讨地耳草免煎颗粒联合耳穴压豆治疗肝胆湿热型急性淤胆型肝炎的临床疗效。方法选取青岛市黄岛区中医医院2013-01-01-2020-03-31治疗的100例中医辩证为肝胆湿热型急性淤胆型肝炎患者为研究对象,采用组间性别、年龄和病程匹配的方法,将100例研究对象分为观察组和对照组各50例。2组患者均应用保肝基础治疗,观察组在对照组基础上加用地耳草免煎颗粒口服联合耳穴压豆治疗,治疗4周后,对比2组患者综合疗效,临床症状缓解及肝功能改善情况。结果观察组患者治愈31例,好转17例,总有效率为96.0%;对照组患者治愈18例,好转24例,总有效率为84.0%,差异有统计学意义,χ^(2)=4.00,P=0.046。治疗后临床证候积分比较,观察组瘙痒(1.61±0.93)分,低于对照组的(2.07±0.95)分,t=2.447,P=0.016;观察组乏力(0.64±0.13)分,低于对照组的(1.42±0.19)分,t=23.958,P<0.001;观察组纳差(0.44±0.12)分,低于对照组的(1.08±0.14)分,t=24.543,P<0.001。肝功能指标比较,观察组总胆红素(TBil)水平为(46.42±6.86)μmol/L,低于对照组的(59.48±8.08)μmol/L,t=8.713,P<0.001;观察组直接胆红素(DBil)水平为(35.11±4.54)μmol/L,低于对照组的(49.07±6.75)μmol/L,t=12.135,P<0.001;观察组总胆汁酸(TBA)水平为(46.38±8.46)μmol/L,低于对照组的(84.66±12.04)μmol/L,t=18.395,P<0.001;观察组碱性磷酸酶(ALP)水平为(70.07±2.11)U/L,低于对照组的(79.83±5.32)U/L,t=12.059,P<0.001;观察组谷氨酰转肽酶(GGT)水平为(120.25±1.16)U/L,低于对照组的(139.85±7.59)U/L,t=18.050,P<0.001。结论肝胆湿热型急性淤胆型肝炎在保肝基础治疗上加用地耳草免煎颗粒联合耳穴压豆治疗总有效率高,临床症状缓解突出,具有改善肝脏功能和利胆退黄的作用,临床疗效满意。

Objective To investigate the clinical effect of the combination of Diercao Mianjian Granule and auricular point pressing on the treatment of acute cholestasis hepatitis of liver,gallbladder,damp and heat.Methods Totally 100 patients with acute cholestatic hepatitis of hepatobiliary damp heat type treated in Huangdao District Hospital of Traditional Chinese medicine of Qingdao from January 1,2013 to March 31,2020 were selected as the research objects,and 100 patients were divided into the observation group and the control group with 50 cases in each group by the method of gender,age and course matching.Two groups of patients were treated with basic treatment of liver protection,and the observation group was treated with Diercao Mianjian Granule combined with auricular point pressing on the basis of the control group.After 4 weeks of treatment,the comprehensive curative effect,clinical symptom relief and liver function improvement of the two groups were compared.Results In the observation group,31 cases were cured,17 cases were improved,and the total effective rate was 96.0%,while in the control group,18 cases were cured,24 cases were improved,and the total effective rate was 84.0%,the difference was statistically significant,χ^(2)=4.00,P=0.046.After treatment,the score of pruritus in the observation group(1.61±0.93)was lower than that in the control group(2.07±0.95),t=2.447,P=0.016.The fatigue score of the observation group was 0.64±0.13,which was lower than that of the control group(1.42±0.19),t=23.958,P<0.001.The difference in tolerance in the observation group was 0.44±0.12,which was lower than that in the control group(1.08±0.14),t=24.543,P<0.001.The total bilirubin(TBil)level in the observation group was(46.42±6.86)μmol/l,which was lower than that in the control group(59.48±8.08)μmol/l,t=8.713,P<0.001.The level of direct bilirubin(DBil)in the observation group was(35.11±4.54)μmol/l,which was lower than that in the control group(49.07±6.75)μmol/l,t=12.135,P<0.001.The total bile acid(TBA)level in the observation group was(46.38±8.46)μmol/l,which was lower than that in the control group(84.66±12.04)μmol/l,t=18.395,P<0.001.The level of alkaline phosphatase(ALP)in the observation group was(70.07±2.11)U/l,which was lower than that in the control group(79.83±5.32)U/l,t=12.059,P<0.001.The level of glutamyl transpeptidase(GGT)in the observation group was(120.25±1.16)U/l,which was lower than that in the control group(139.85±7.59)U/l,t=18.050,P<0.001.Conclusions In addition to the basic treatment of liver protection,the total effective rate of acute cholestasis hepatitis with liver damp-heat type treated with Diercao Mianjian Granule combined with auricular point pressing is high,and the clinical symptoms are alleviated remarkably and have the effects of improving liver function and promoting gallbladder and retreating yellowing,and the clinical effect is satisfactory.