清热解毒化浊片对慢性病毒性肝炎湿热内蕴证、肝郁脾虚证疗效的研究

A Clinical Study on the Therapeutic Effects of Qingre Jiedu Huazhuo Tablets on the Patients of Chronic Viral Hepatitis B with Different Patterns

目的探讨清热解毒化浊片对慢性病毒性肝炎不同中医证型的疗效。方法选取慢性乙型病毒性肝炎患者中医辨证为湿热内蕴型 1 6例 ,肝郁脾虚型 1 5例 ,两组均给予清热解毒化浊片口服治疗 ,1个月后观察其对肝功能、肝纤指标及内毒素的影响。结果治疗后两组中医证候积分、ALT、AST、TBIL、内毒素均较治疗前显著下降 ,湿热内蕴组甘胆酸 (CG)、肝郁脾虚组透明质酸 (HA)显著下降。结论清热解毒化浊片具有良好的护肝、抗肝纤作用 ,其机理可能与清除血浆内毒素 ,终止肝损伤的恶性循环有关。同时提示慢性乙型病毒性肝炎的中医基本病机为湿热内蕴 ,即使辨证为肝郁脾虚 ,也可有湿热余邪内伏 ,清除余邪可帮助提高疗效 ,该药临床既可用于辨证论治 ,亦可用于辨病论治 ,只是疗效因证型不同而各有侧重。

Objective To investigate the therapeutic effects of Qingre Jredu Huazhuo Tablets(QJHT) on the patients of chronic viral hepatitis B(CVHB) with the pattern of dampness-heat internally retaining(DHIR) or Liver-depression Spleen-deficiency(LDSD).Methods 16 cases of CVHB with the pattern of DHIR and 15 cases of CVHB with the one of LDSD were included in this study,all being treated with QJHT. During the period of treatment,the therapeutic effects of QJHT on CVHB of different patterns were observed and compared among these cases.Results The symptoms of these two patterns were all improved among these cases effectively while the degree of improvemant was superior in the group of DHIR to that in the one of LDSD (P<0.05).Furthermore, other effects of QJHT were almost the same for these cases with different patterns,especially like these effects on the levels of ALT,AST,TBL and endotoxin and the lesion of hepatic fibrosis.Conclusions QJHT is effective in hepatocytes-protecting,hepatic fibrosis-treating and endotoxin-eliminating for cases of CVHB with different patorns while it may be a little more effective for the symptoms improving among patients with the pattern of DHIR.