苦参碱对不同中医证型乙肝肝硬化疗效的临床观察

目的观察苦参碱治疗不同中医证型乙肝肝硬化患者的临床疗效。方法回顾性分析2012年4月~2013年3月在我院住院并符合纳入标准的患者共55例,根据中医辨证分为湿热型和非湿热型,治疗方案相同,比较两组的临床疗效。结果治疗4周后,湿热组有19例(79.17%)好转,非湿热组有12例(38.71%)好转,湿热组好转率优于非湿热组,两者比较,差异有统计学意义(P<0.05);两组治疗后的丙氨酸氨基转氨酶(ALT)、天门冬氨酸氨基转氨酶(AST)均有明显下降,湿热组患者的总胆红素(TBIL)、前白蛋白(PA)、凝血酶原时间(PT)改善明显(P<0.01)。结论苦参碱治疗湿热型乙肝肝硬化患者,总体较非湿热型患者更有效,为临床选择适合的乙肝肝硬化患者进行苦参碱治疗提供参考,体现了中西医结合治疗的特色。

Clinical Observation of the Efficacy of Matrine on Cirrhosis in Hepatitis B

Objective To observe the clinical efficacy of matrine on cirrhosis in hepatitis B differ-entiated as the different patterns/syndromes in traditional Chinese medicine （TCM）. Methods Fifty-five patients admitted from April 2012 to March 2013 were analyzed and enrolled as the qualified subjects. Ac-cording to the pattern/syndrome differentiation in TCM, the cases were differentiated into damp heat pattern and non - damp - heat pattern. The therapeutic program was same and the clinical efficacy was compared be-tween the two groups. Results In 4 weeks of treatment, 19 cases （79.17%） were improved in the damp - heat group and 12 cases （38.71% ）were improved in the non -damp -heat group. The improvement rate in the damp - heat group was better than that in the non - damp - heat group, indicating the significant differ-ence（ P 〈 0.05 ）. The levels of ALT and AST were reduced apparently after treatment in the two groups. The results in TBIL, PA and PT were improved obviously in the damp - heat group （P 〈 0.01 ）. Conclusion The overall efficacy of matrine is much higher in the patients of cirrhosis in hepatitis B of damp heat pattern/syn-drome as compared with those of non - damp - heat patterrL/syndrome. It provides the reference for the clini-cal treatment of cirrhosis in hepatitis B for the suitable patients and embodies the feature of integrated Chi-nese and western medicine.