中医药辨证治疗慢性乙型重型肝炎疗效分析

目的:探讨中医药辨证治疗对慢性乙型重型肝炎(CSHB)患者生存率的影响及其治疗作用。方法:根据国家"十一五"科技重大专项"慢性重型肝炎证候规律及中西医结合治疗方案研究"课题要求,采用前瞻性的研究方法,以2009年5月—2010年1月在杭州市第六人民医院住院的CSHB入组患者为研究对象,按随机的方法分为试验组和对照组,对照组以基础治疗和对症治疗为主,试验组在基础治疗和对症治疗的基础上加用中医药辨证治疗和中药保留灌肠治疗,随访48周,对其生存时间,生化指标等进行监测。共完成试验组53例,对照组50例。结果:(1)两组在各时段累计生存率上有明显差别,其差别有统计学意义(P0.05),试验组在各时段累计生存率明显优于对照组。(2)两组第0周,总胆红素及凝血酶原时间数值均处于较高水平,差别无统计学意义,第4周、第8周试验组总胆红素及凝血酶原时间数值高于对照组,差别有统计学意义。第12周以后两组总胆红素及凝血酶原时间均处于较低水平,其差别无统计学意义;试验组AFP值在各期数值均高于对照组,其差别无统计学意义。结论:在基础治疗和对症治疗的基础上,采用中医辨证论治,辅以中药留灌肠能明显改善CSHB患者生存率,减慢病情发展速度,改善其预后,并可改善患者总胆红素、凝血酶原时间的指标。

Clinical Analysis of TCM Differential Treatment on Severe Chronic Hepatitis B

Objective:To explore the survival rate and its therapeutic of the TCM differential treatment on severe chronic hepatitis B(CSHB)patients.Methods:According to requirements of the major science and technology projects of National 11th five-year plan-the TCM syndromes characteristics and combined therapy of traditional Chinese medicine and western medicine of severe chronic hepatitis B,we used forward-looking research methods.The patients that from May 2009-January 2010 in Hangzhou Sixth People’s Hospital of CSHB in groups were observed,they were randomly divided into test group and control group,we gave control group based treatment and symptomatic treatment,the test group were given basic treatment,symptomatic treatment,TCM differential treatment and herbal enema.They were followed for 48 weeks,their survival time and biochemical indicators were monitored.At the end 53 patients of the test group and 50 patients of control group finished the research.Results:(1)There were significant difference in cumulative survival rate between the two groups,the difference was statistically significant(P<0.05),the cumulative survival rate of test group was significantly higher than that of control group in each time.(2)The total bilirubin(TBil)and prothrombin time(PT)were at a high level in each group at the first week,the difference had no statistical meaning,but in the 4th and 8th week the TBil and PT were significantly different between the two groups.In the test group,the TBil and PT were significantly higher,the difference was statistical.12 weeks later,the TBil and PT in each group were at a low level,the difference was not statistically significant.The AFP levels were also observed,the test group was commonly higher than control group,but the difference was not statistical.Conclusion:Based on the basic treatment and symptomatic treatment,TCM differential treatment and herbal enema can significantly improve the survival rate,slow down the rate of progression of the disease,improve the prognosis,and lower patients total bilirubin as well as prothrombin time index.