疏肝祛湿清热方治疗湿热内蕴型肝硬化临床观察

Clinical Observation of Shugan Qushi Qingre Recipe in the Treatment of Liver Cirrhosis with Syndrome of Internal Accumulation of Damp-Heat

目的探讨疏肝祛湿清热方治疗湿热内蕴型肝硬化的临床疗效。方法选取重庆市荣昌区中医院2016年12月至2020年7月收治的湿热内蕴型肝硬化患者80例,按随机数字表法分为对照组与试验组,各40例。对照组患者给予常规西医治疗,试验组患者在对照组治疗基础上加用疏肝祛湿清热方,均治疗6个月。结果试验组总有效率为92.50%,显著高于对照组的75.00%(P<0.05);与治疗前比较,两组患者治疗后的中医证候(主症和次症)积分均显著降低,且试验组显著低于对照组(P<0.05);两组患者治疗后的肝纤维化指标(层粘连蛋白、Ⅳ型胶原、透明质酸酶)、肝功能指标(丙氨酸氨基转移酶、天门冬氨酸氨基转移酶)水平均显著降低,且试验组显著低于对照组(P<0.05);B超检查结果显示,试验组患者病变消退率为92.50%,显著高于对照组的75.00%(P<0.05);试验组和对照组患者治疗期间均未发生肾功能损害及心电图、血尿常规异常,不良反应发生率相当(10.00%比7.50%,P>0.05)。结论疏肝祛湿清热方治疗湿热内蕴型肝硬化临床疗效良好,可降低患者的中医证候积分,改善肝纤维化和肝功能,且治疗安全性高。

Objective To investigate the clinical efficacy of Shugan Qushi Qingre Recipe in the treatment of liver cirrhosis with the syndrome of internal accumulation of damp-heat.Methods A total of 80 liver cirrhosis patients with the syndrome of internal accumulation of damp-heat admitted to the Chongqing Rongchang District Hospital of Traditional Chinese Medicine from December 2016 to July 2020 were selected and divided into the control group and the test group according to the random number table method,with 40 cases in each group.The patients in the control group were treated with conventional western medicine,on this basis,the patients in the test group were treated with Shugan Qushi Qingre Recipe.Both groups were treated for six months.Results The total effective rate in the test group was 92.50%,which was significantly higher than 75.00%in the control group(P<0.05).Compared with those before treatment,the scores of traditional Chinese medicine(TCM)syndromes(main and secondary syndromes)in the two groups significantly decreased after treatment,and those in the test group were significantly lower than those in the control group(P<0.05).Compared with those before treatment,the levels of the liver fibrosis indexes(laminin,typeⅣcollagen and hyaluronidase)and the liver function indexes[alanine aminotransferase(ALT)and aspartate aminotransferase(AST)]in the two groups significantly decreased after treatment,and those in the test group were significantly lower than those in the control group(P<0.05).The results of B-ultrasonic examination showed that the lesion regression rate in the test group was 92.50%,which was significantly higher than 75.00%in the control group(P<0.05).During the treatment,there was no renal function damage,abnormal electrocardiogram(EGG),abnormal results of blood and urine routine tests occurred in the two groups,and the incidence of adverse reactions in the test group was similar to that in the control group(10.00%vs.7.50%,P>0.05).Conclusion Shugan Qushi Qingre Recipe is effective and safe in the treatment of liver cirrhosis with the syndrome of internal accumulation of damp-heat,which can decrease the TCM syndrome scores,improve the liver fibrosis and liver function of patients.