疏肝健脾方联合中医定向透药对乙型肝炎肝硬化患者肝脏硬度值、血清Ⅳ型胶原水平及凝血功能的影响

Effects of Shugan Jianpi prescription combined with TCM directional permeabilization on liver stiffness measurement value,serum COL IV level and blood coagulation function in patients with hepatitis B cirrhosis

目的:探讨疏肝健脾方联合中医定向透药对乙型肝炎肝硬化患者肝脏硬度值(LSM)、血清Ⅳ型胶原(COLⅣ)水平及凝血功能的影响。方法:以上海市浦东传染病医院2021年1月至12月收治的84例乙型肝炎肝硬化患者为研究对象,利用计算机软件生成随机数,将其分为对照组(n=42)和研究组(n=42)。所有患者接受常规西药治疗,在此基础上对照组患者加用疏肝健脾方,研究组患者在对照组基础上开展中医定向透药治疗。比较两组患者治疗前、治疗6个月后中医证候积分、LSM、肝纤维化指标[COLⅣ、Ⅲ型前胶原(PC-Ⅲ)]及凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)],并判定两组患者治疗6个月后临床疗效。结果:研究组患者治疗总有效率明显较对照组高(P<0.05);两组患者治疗后中医证候积分、LSM及血清COLⅣ、PC-Ⅲ水平与本组治疗前相比均明显降低(P<0.05),且研究组均明显低于对照组(P<0.05);两组患者治疗后PT、APTT与本组治疗前相比均明显缩短(P<0.05),TT组间比较差异无统计学意义(P>0.05),研究组患者治疗后PT、APTT明显较对照组短(P均<0.05)。结论:疏肝健脾方联合中医定向透药治疗乙型肝炎肝硬化患者效果较为理想,可明显降低患者中医证候积分及肝脏硬度,有效控制肝纤维化,显著改善凝血功能。

Objective:To explore the effects of Shugan Jianpi Prescription combined with TCM directional permeabilization on liver stiffness measurement(LSM)value,serum collagen type IV(COL IV)level,and blood coagulation function in patients with hepatitis B cirrhosis.Methods:A total of 84 patients with hepatitis B cirrhosis admitted to Shanghai Pudong Infectious Disease Hospital from January 2021 to December were used as the research objects.Computer software was used to generate random numbers and the patients were divided into a control group(n=42)and a study group(n=42).All patients received conventional Western medicine treatment,on this basis,the control group was treated with Shugan Jianpi Prescription,and the study group was treated with TCM directional permeabilization on the basis of the control group.The scores of TCM syndromes,LSM,liver fibrosis indexes[COLⅣ,procollagen typeⅢ(PC-Ⅲ)]and coagulation function indexes[prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT)]were compared between the two groups before treatment and six months after treatment,and the efficacy of the two groups were determined after six months of treatment.Results:The total effective rate of treatment in the study group was significantly higher than that in the control group(P<0.05),After treatment,the TCM syndrome scores,LSM and serum COL IV,PC-Ⅲlevels of the two groups were significantly lower than those of the same group before treatment(P<0.05),and the study group were significantly lower than the control group(P<0.05).After treatment,PT,APTT in the two groups were significantly shorter than those before treatment in the same group(P<0.05),and there was no significant difference in TT between the two groups(P<0.05),and after treatment,PT and APTT in the study group was significantly shorter than those in the control group(P<0.05).Conclusion:The effect of Shugan Jianpi Prescription combined with TCM directional permeabilization for patients with hepatitis B liver cirrhosis is relatively ideal.It can significantly reduce the TCM syndrome score and liver stiffness,effectively control liver fibrosis,and significantly improve blood coagulation.