凉血解毒、清热化湿和凉血解毒、健脾温阳法治疗慢性重型肝炎的临床观察

目的 观察凉血解毒、清热化湿法（简称清热化湿法）和凉血解毒、健脾温阳法（简称健脾温阳法）治疗慢性重型肝炎阴阳黄证的初步疗效，为黄疸的中医治疗提供思路。方法 采用随机、对照方法，进行中医辨证治疗慢性重型肝炎43例，重点观察比较清热化湿、健脾温阳两法消退黄疸的作用。结果 治疗4周后，清热化湿组22例，有效16例（72．7％），无效6例（27．3％）；健脾温阳组21例，有效19例（90．5％），无效2例（9．5％）；两组疗效比较差异无显著性。TBIL：治疗后两组均下降（P〈0．01），且健脾温阳组下降的幅度大于清热化湿组（P〈0．05）；凝血酶原活动度：健脾温阳组上升幅度优于清热化湿组（P〈0．05）；ALT：两组均降低（P〈0．05），但两组间比较差异无显著性。结论 凉血解毒、健睥温阳法治疗慢性重型肝炎阴阳黄证的疗效优于凉血解毒、清热化湿法。

Clinical Observation on Chronic Severe Hepatitis B Treated by Principles of Cooling-Blood and Detoxicating Combined with Clearing-Heat and Resolving-Damp or Combined with Strengthening-Pi and Warming-Yang

ObjectiveTo observe the therapeutic efficacy on chronic severe hepatitis B (CSH) patients of Yanghuang and Yinhuang syndrome type by principles of cooling-blood and detoxicating combined with clearing-heat and resolving dampness (PA) or with strengthening-Pi and warming-yang (PB), respectively. Methods Forty-three patients with CSH were randomly divided into two groups, group A (22 cases) treated with PA and group B (21 cases) with PB. The therapeutic efficacy, laying stress on the effect in eliminating jaundice, was observed. Results The efficacy in group B was effective in 19 cases (90.5), and ineffective in 2(9.5), while in group A, effective in 16 (72.7) and ineffective in 6 (27.3). Levels of TBIL and ALT were significantly lower in both groups (P<0.05 or P<0.01), and the descending extent was greater, the thrombinogen activity was higher in group B than that in group A after treatment (P<0.05), no significant difference in ALT was found between the two groups. Conclusion The efficacy of PB is better than that of PA on CSH with Yanghuang and Yinghuang syndrome.