| 引用本文:张博1，张静2，李乔1.自拟清热化湿疏肝汤治疗乙肝肝硬化（湿热内蕴证）的临床疗效观察[J].世界中医药,2019,(12):. |
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| 自拟清热化湿疏肝汤治疗乙肝肝硬化（湿热内蕴证）的临床疗效观察 |
| Effect Analysis of Self-Made Qingre Huashi Shugan Decoction in Patients with Post-Hepatitis B Cirrhosis(Internal Accumulation of Damp-Heat Syndrome) |
| 投稿时间：2019-03-02 |
| DOI：10.3969/j.issn.1673-7202.2019.12.027 |
| 中文关键词: 清热化湿疏肝汤 乙肝 肝硬化 湿热内蕴证 抗乙肝病毒治疗 临床疗效 肝功能 症状评分 |
| English Keywords:Self-made Qingre Huashi Shugan Decoction Post-hepatitis B cirrhosis Internal accumulation of damp-heat syndrome |
| 基金项目:国家自然科学基金项目（30701070）——茵陈蒿汤治疗肝硬化的方证病理基础研究 |
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| 中文摘要: |
| 目的：探讨分析自拟清热化湿疏肝汤治疗乙肝肝硬化（湿热内蕴证）的疗效。方法：选取2018年10月至2019年3月中国中医科学院广安门医院南区收治的乙肝肝硬化（湿热内蕴证）患者104例作为研究对象，按照随机数字表法随机分为观察组和对照组，每组52例。对照组给予常规西药（拉米夫定+富马酸替诺福韦二吡呋酯片+复方甘草酸苷）治疗，观察组在常规西药治疗的同时给予自拟清热化湿疏肝汤治疗，2组均持续治疗6个月。比较2组患者治疗前后症状评分、肝功能、肝纤维化指标变化、临床疗效和安全性。结果：与治疗前比较，2组治疗后主症、次症和总症状评分，血清ALT、AST和r-GGT水平，血清HA、PC-III、IV-C、LN水平水平均下降（P<0.05），且治疗后观察组上述评分和血清学指标均低于对照组（P<0.05）；观察组临床疗效与对照组比较，差异有统计学意义（P<0.05），且观察组总有效率为94.23%，明显高于对照组的78.85%（P<0.05）；2组不良反应发生率比较，差异无统计学意义（P>0.05），且均未出现肾损害。结论：对乙肝肝硬化（湿热内蕴证）患者在常规西药治疗的同时给予自拟清热化湿疏肝汤可减轻症状，改善肝功能，控制肝纤维化，且疗效理想，安全可靠。 |
| English Summary: |
| To explore and analyze on the effect of self-made Qingre Huashi Shugan Decoction in patients with post-hepatitis B cirrhosis(internal accumulation of damp-heat syndrome).Methods:A total of 104 patients with post-hepatitis B cirrhosis(internal accumulation of damp-heat syndrome)were selected and divided into a western medicine group and a research group with a random number table generated by computer, with 52 cases in each group.Western medicine group was treated with routine western medicine(lamivudine+tenofovir fumarate dipyridamole tablets+compound glycyrrhizin), while the research group was treated with self-made Qingre Huashi Shugan Decoction at the same time of routine western medicine treatment, which lasted for 6 months.The changes of symptom scores, liver function and liver fibrosis indexes before and after treatment were compared, and the clinical efficacy and safety were compared.Results:Compared with before treatment, the main symptoms, secondary symptoms and total symptoms scores, serum ALT, AST and r-GGT levels, serum HA, PC-III, IV-C and LN levels in the 2 groups decreased after treatment(P<0.05), and the above scores and serological indicators in the study group were lower than those in the western medicine group after treatment(P<0.05).The clinical efficacy distribution of the study group was significantly different from that of the western medicine group(P<0.05), and the total effective rate of the study group was 94.23%, which was significantly higher than that of 78.85% in the western medicine group(P<0.05).The incidences of adverse reactions in the 2 groups were similar(P>0.05), and there was no renal damage.Conclusion:The self-made Qingre Huashi Shugan Decoction can alleviate symptoms, improve liver function and control liver fibrosis in patients with post-hepatitis B cirrhosis(internal accumulation of damp-heat syndrome)while being treated with conventional western medicine.It has ideal curative effect and is safe and reliable. |
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