柔肝化纤颗粒联合西药治疗慢性乙肝肝纤维化随机平行对照研究

[目的]观察柔肝化纤颗粒联合西药治疗慢性乙肝肝纤维化疗效。[方法]使用随机平行对照方法,将52例门诊及住院患者按抛硬币法随机分为两组。对照组26例保肝对症治疗,维生素C、肝泰乐以及肌苷、甘利欣等。治疗组26例柔肝化纤颗粒(大枣、鸡内金各15g,黄芪45g,虎杖、枸杞、黄精各20g,牡丹皮12g,橘红10g,薏苡仁45g,牡蛎、泽兰、鳖甲30g),磨粉冲服,150g/次,2次/d。西药治疗同对照组。连续治疗半年为1疗程。观测临床症状、肝功能指标、脾脏厚度、门静脉内径、门静脉流速(A/P)、肝动脉收缩期最大流速、血清肝纤维化、不良反应。治疗1疗程(半年),判定疗效。[结果]治疗组痊愈5例,显效10例,有效9例,无效2例,总有效率92.31%。对照组痊愈1例,显效7例,有效10例,无效9例,总有效率65.38%。治疗组疗效优于对照组(P0.05)。肝功能两组均有改善(P0.05),治疗组改善优于对照组(P0.05)。两组血清纤维化指标及门脉内径、A/P、脾脏厚度均有改善(P0.05),治疗组改善优于对照组(P0.05)。外周血免疫活性细胞绝对值两组改善治疗组优于对照组(P0.05)。[结论]柔肝化纤颗粒联合西药治疗慢性乙肝肝纤维化效果显著,值得推广。

Liver Fiber Particles Combined Western Medicine Treatment of Chronic Hepatitis b Liver Fibrosis Random Parallel Control Study

[ Objective ] To observe the liver fiber particles combined western medicine treatment of chronic hepatitis b liver fibrosis. [ Methods ] Using random parallel control method, according to 52 cases of outpatient and inpatient will flip a coin method were randomly divided into two groups. The control group, 26 cases of liver symptomatic treatment, vitamin C, liver and inosine, GanLiXin, etc. Treatment group 26 cases liver fiber particles （Dazao, Jineijin each15g, Huangqi45g, Huzhang, Gouqi, Huangjing each 20g, Mudanpi 12g, Juhong 10g, Yiyiren 45g, Muli, Zelan, Biejia 30g ）. Grinding blunt, 150 g/times, 2 times/d. Western medicine treatment with the control group. Continuous treatment for half a year to 1 course of treatment. Observation of clinical symptoms, liver function index [ propagated, AST, ALT, TBIL ], thickness of spleen, portal vein diameter, portal venous velocity （ A/P ）, hepatic artery systolic maximum velocity and serum liver fibrosis [ PC III, HA, C-IV, LN, peripheral blood immune active cells （ total lymphocyte, CD4＋, CD8＋T cells, NK cells and NKT cells ） ], adverse reactions. Treatment as a course （ half year ）, to determine efficacy. [ Results ] The treatment group healed in 5 cases, 10 cases were markedly effective, effective 9 cases, ineffective in 2 cases, total effective rate was 92.31%. The control group recovered in 1 case, 7 cases had marked effect, 10 cases were effective, 9 no effect, the total effective rate was 65.38%. The treatment group curative effect is better than that of control group （ P〈0.05 ） . Two groups of liver function were improved （ P〈0.05 ）, the treatment group is better than that of control group （ P〈0.05 ） . Two groups of serum fibrosis index door vein diameter and the thickness of the A/P, spleen have improved （ P〈0.05 ）, the treatment group is better than that of control group （ P 〈0.05 ） . Two groups of peripheral immune active cells in absolute value to improve the treatment group is better than that of control group （ P〈0.05 ） . [ Conclusion ] Liver fiber particles combined western medicine treatment of chronic hepatitis b liver fibrosis effect is remarkable, is worth promoting.