自拟降酶汤治疗肝功能异常68例疗效观察

肝功能异常是肝脏疾病中最常见的临床表现之一，通常以胆红素、转氨酶升高，白蛋白降低为主。多见于急、慢性病毒性肝炎、慢性酒精中毒性肝炎、肝硬化、肝癌中晚期、药物性肝炎、寄生虫病肝损害等。降酶汤是著名中医肝病专家，吾师龙治平主任医师在长期肝病诊治临床中总结而成的经验方，保肝降酶疗效显著。现将近期运用降酶汤治疗肝功能异常68例报告如下，并以联苯双酯治疗作对照。1临床资料本组病例68例，于97年至98年8月间在门诊收治60例，病房治疗8例。年龄最小6岁，最大65岁，以20至45岁为多。其中女性21例，男性47例。急性黄疽型肝炎28…     

孙定隆老师运用降酶汤治疗乙肝谷-丙转氨酶升高的经验

急慢性乙型病毒性肝炎中谷-丙转氨酶(ALT)升高者并不少见。笔者在贵阳中医学院一附院进修时有幸跟随中医消化内科孙定隆老师。见老师采用“降酶汤”治疗急慢性乙型肝炎肝功能异常者,疗效显著,现介绍如下:1临床资料1·1一般资料22例均为门诊病例。其中男14例,女8例;年龄最大55岁     

李幼昌用八味逍遥汤治疗妇科病临床经验

李幼昌教授是国家第一批中医传承导师之一,毕生耕耘临床,经验丰富,疗效突出,八味逍遥汤是李老治疗妇科病的习用方,现总结报道如下。     

自拟健脾降酶汤治疗转氨酶升高36例

血清丙氨酸氨基转移酶（ALT）升高是反映肝细胞损害的表现，是临床上用来衡量肝功能的一项重要指标，它虽不具有特异性．但其高度的灵敏性被临床医师普遍认同。在临床看到，部分慢性肝炎病人ALT反复波动或持续升高常使病人情绪不安与紧张。所以降酶治疗对于稳定病人情绪与改善病情均有裨益。慢性肝病和结核病病人在我国具有较多的人群。慢性肝病本身对肝脏的损害和长期服用抗结核药对肝脏的损害已被人们广泛关注。笔者近几年来，利用门诊病人复诊率高的特点，以辨证论治为指导原则，对转氨酶升高的36例病人用自拟健脾降酶汤进行治疗，取得满意的疗效，现报道如下：[第一段]     

潘智敏教授应用清肺八味汤经验介绍

潘智敏教授总结前贤和杨继荪先生的临证经验，联系临床实际，在临床常见的咳嗽咳痰治疗过程中，常以清热解毒为法，并认为"黄痰固为有热、白痰未必有寒"。有感于痰由热毒生的病机特点，潘教授在临床中用自拟清肺八味汤加减作为咳嗽咳痰的主要治疗药物，尤其在社区获得性肺炎、慢性阻塞性肺疾病、吸入性肺炎等病见发热及咳嗽咳痰症状者的治疗方法，缩短了患者使用抗生素的时间和住院时间，收到良好的临床效果。     

邵铭教授运用茵陈玉露饮治疗肝病经验

茵陈玉露饮出自费伯雄的《医醇賸义》,由茵陈蒿、玉竹、石斛、天花粉、葛根、山栀子、萆薢等11味药物组成,诸药合用,共奏养阴清利,健脾和胃之效。文章通过临床典型病案,论述邵铭教授运用茵陈玉露饮治疗自身免疫性肝病的临床经验。文章所述自身免疫性肝炎、原发性胆汁性胆管炎,虽病症不同,但均有津亏夹湿之象,皆可用茵陈玉露饮加减取效,从而获得了异病同治的治疗效果,拓展了中医中药治疗自身免疫性肝疾病的思路和范围。     

自拟健脾降酶汤治疗转氨酶升高36例

血清丙氨酸氨基转移酶(ALT)升高是反映肝细胞损害的表现,是临床上用来衡量肝功能的一项重要指标,它虽不具有特异性,但其高度的灵敏性被临床医师普遍认同。在临床看到,部分慢性肝炎病人ALT反复波动或持续升高常使病     

Clinical study on treatment of chronic viral cholestatic hepatitis with Chishaodanpi decoction

ObjectiveTo observe the therapeutic effect of Chishaodanpi decoction (CSDPD) on chronic viral cholestatic hepatitis.MethodsA total of 107 subjects with chronic viral cholestatic hepatitis were enrolled in our hospital from March 2007 to November 2012. Patients were randomly divided into treatment (54 cases) and control groups (53 cases). The control group was treated with potassium magnesium aspartate, diammonium glycyrrhizinate, glucurolactone, vitamin C, and lamivudine, once a day. The treatment group was treated with modified CSDPD, 100 mL a time, twice a day, in addition to the treatment given to the control group. The patients in both groups were treated for 8 weeks. The main symptoms and signs were recorded every day throughout the clinical trial. Before and after the trial, changes in liver function including total bilirubin (TBil), direct bilirubin (DBil), total bile acid (TBA), and the activities of alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and γ-glutamyl transferase (γ-GT), were all detected. Adverse reactions were also recorded.ResultsThere were no differences in gender, age, disease duration, symptoms, signs, or laboratory findings between the two groups (P>0.05). After an 8-week treatment, improvements in jaundice, weakness, poor appetite, abdominal distention, and skin itching were significantly better in the treatment group than in the control group (P<0.05). In the treatment group, 43 patients had a significant response to the treatment, seven patients had a response, and four patients had no response, with 21, 12, and 20 patients in the control group, respectively. The total effective rate was 92.6% in the treatment group and 62.3% in the control group, which was a significant difference (P<0.05). The levels of TBil, DBil, TBA, ALP, ALT, AST, and γ-GT in both groups were significantly lower after treatment, and were significantly different between the two groups (P<0.05). A few patients in the treatment group had mild adverse effects such as increased bowel movement frequency and mild stomachache. No other adverse reactions were observed in either group.ConclusionCSDPD has a satisfactory therapeutic effect on chronic viral cholestatic hepatitis.     

黄芪建中汤合理中汤治疗脾胃虚寒型慢性胃炎患者的效果

目的:观察黄芪建中汤合理中汤治疗脾胃虚寒型慢性胃炎患者的效果。方法:选取86例脾胃虚寒型慢性胃炎患者为研究对象,按照随机数字表法分为观察组与对照组各43例。对照组采用常规四联疗法治疗,观察组在对照组基础上采用黄芪建中汤合理中汤治疗,比较两组临床疗效、临床症状缓解时间和不良反应发生率。结果:观察组治疗总有效率为95.35%,明显高于对照组的76.74%,差异有统计学意义(P<0.05);观察组胃痛、嗳气、恶心呕吐缓解时间均短于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:在常规四联疗法基础上应用黄芪建中汤合理中汤治疗脾胃虚寒型慢性胃炎患者可提高治疗总有效率,缩短临床症状缓解时间,效果优于单纯常规四联疗法。     

二草清肝汤联合干扰素治疗慢性乙型肝炎疗效观察

干扰素或核苷类药物均通过抗病毒治疗抑制或清除乙型肝炎病毒（HBV）治疗慢性乙型肝炎（CHB）,延缓疾病进展,降低肝硬化及肝细胞癌的发生几率。笔者应用二草清肝汤联合干扰素治疗慢性乙型肝炎患者,观察前者是否有助增强干扰素的抗病毒、保肝护肝、抗纤维化等作用,并减轻后者的毒副作用,现报道如下。     

Comparison on efficacy between Astragalus-Polygonum Anti-Fibrosis decoction and Jinshuibao () capsule in Treating liver fibrosis of chronic hepatitis B) capsule in Treating liver fibrosis of chronic hepatitis B

Objective: To observe the efficacy of Astragalus-Polygonum Anti-Fibrosis decoction (APAFD) and Jinshuibao capsule (JSBC) in treating liver fibrosis of chronic hepatitis B.Methods: Ninety-two cases of liver fibrosis of chronic hepatitis B were randomly divided into group A and group B. Patients in group A received APAFD for 48 weeks, and in group B, they received JSBC for 48 weeks. The effects on the level change of hyaluronic acid (HA), laminin (LN), pro-collagen III (PCIII) and collagen IV (CIV) as well as liver functional tests and liver biochemical parameters before and after treatment were observed.Results: Level of serum HA, LN, PCIII and CIV in group A declined more obviously than that of group B, the difference was significant (P < 0.01). The liver functional tests such as total bilirubin (TB), alanine aminotransferase (ALT), albumin/ globulin (A/G) ratio, hepatitis related serum biochemical parameters such as cholylglycine (CG), serum ferritin (SF), prealbumin (PC) of group A were all improved more significantly than that of group B (P < 0.01).Conclusion: APAFD is more effective than JSBC in treating liver fibrosis of chronic hepatitis B and in the inhibition of hepatic inflammation, hence it is a good composite Chinese herbal preparation against liver fibrosis.     

慢肝汤治疗慢性乙型肝炎129例疗效观察

目的：评估慢肝汤对慢乙肝轻度、中度和肝炎后肝硬化稳定期的临床疗效。方法：选择84例慢性乙肝轻度,33例慢乙肝中度和12例肝炎后肝硬化稳定期患者口服慢肝汤,回顾性统计分析和比较检查结果（症状、体征和血清ALT、AST、SB、HBsAg、HbeAg及抗－HBc等）。结果：慢性轻度总有效率为85．7％,慢性中度和肝硬化稳定期总有效率均为66．7％。结论：慢肝汤为一种治疗慢性乙型病毒性肝炎的安全、有效的治疗方剂。     

人抗乙肝特异转移因子治疗慢性乙肝27例临床观察

目的：探索慢性乙型肝炎（简称慢乙肝）的免疫调节治疗。方法：用乙型肝炎病毒（HBV）疫苗多次免疫健康的供血员，使之产生强的免疫应答，然后分离白细胞，从中提取转移因子（暂称“人抗乙肝特异转移因子”或“乙型肝炎高度特异转移因子”，HSTF）。先后二次进行临床观察，治疗组27例慢性乙肝患才HSTF治疗，对照组15例慢性乙肝患才乙肝胎盘肽（PSTF）治疗，结果：HBeAg阴转治疗组为14／27例，对照组为2／15例（P＜0．05);HBsAg阴转治疗组为4／27，对照组为0／15例，两次应用HSTF过程中，未发现不良反应。结论：初步的临床研究表明，HSTF不仅能改善慢乙肝患的临床症状，还能改善患体内的乙肝病毒标记物（HBVM），其疗效高于PSTF，能达到与单独应用干扰能（rIFN α2b）类似的疗效；本疗法疗程短，费用低，未见不良反应，在目前对HBV缺乏特效抗病毒药的情况下，HSTF有临床应用价值，值得进一步研究。     

加味茵陈蒿汤治疗急性黄疸型肝炎疗效分析

目的观察加味茵陈蒿汤治疗急性黄疸型肝炎的临床效果。方法将符合《病毒性肝炎防治方案》所制订的急性黄疸型肝炎诊断标准的83例患者随机分成治疗组和对照组,两组均常规每天给予门冬氨酸钾镁注射液、肝安注射液静脉滴注,口服维生素C、肝太乐、维生素B6。治疗组45例在此基础上给予加味茵陈蒿汤每天1剂,水煎服,4周后复查肝功能。结果两组治愈率比较差异有统计学极显著意义（P〈0．01）,总有效率比较差异有统计学显著意义（P〈0．05）。结论加味茵陈蒿汤治疗急性黄疸型肝炎疗效确切,值得推广。     

柔肝煎联合拉米夫定对慢性乙型肝炎患者E抗原及乙型肝炎病毒复制指标的影响

目的：观察自拟中药方剂柔肝煎对慢性乙型肝炎患者E抗原及乙型肝炎病毒复制的影响。方法：将65例慢性乙型肝炎患者随机分为治疗组和对照组,治疗组35例以柔肝煎联合应用拉米夫定治疗,对照组30例单纯应用拉米夫定治疗,疗程均为6个月,观察治疗前后E抗原及乙型肝炎病毒复制等指标的变化。结果：两组血清乙型肝炎病毒阴转率未见显著差别（P〉0.05）,但治疗组HBeAg阴转率及ALT复常率均显著高于对照组（两组P值均小于0.01,有统计学差异）,且未发现明显不良反应。结论：柔肝煎联合应用拉米夫定对慢性乙型肝炎患者病毒血清学指标及肝功能指标的控制总体效果好于单纯应用拉米夫定,且安全性好。     

自拟参苓山蛸汤治疗脾胃虚弱型胃炎

目的 观察自拟参苓山蛸汤对脾胃虚弱型胃炎的临床疗效.方法 选取105例脾胃虚弱型胃炎患者,随机分为治疗组和对照组,治疗组60例采用自拟参苓山蛸汤(太子参、茯苓、山药、海螵蛸)治疗,对照组45例使用雷尼替丁治疗.比较2组总有效率、不良反应发生率及安全性.结果 治疗组总有效率95.0％,对照组总有效率88.9％(P＞ 0.05),治疗组显效率58.3％优于对照组17.8％ (P＜0.05).治疗组不良反应发生率3.3％,低于对照组的17.8％(P＜ 0.05).结论 自拟参苓山蛸汤治疗脾胃虚弱型胃炎,能有效改善临床症状,降低不良反应发生率.