清肝化瘀方联合西医常规疗法治疗慢性重型肝炎临床研究

目的探讨清肝化瘀方联合西医常规疗法治疗慢性重型肝炎湿热瘀血证的临床疗效及其对患者炎性指标、生化指标、凝血功能的影响。方法采用随机数字表法将87例患者分为观察组(44例)和对照组(43例)。对照组予西医常规治疗及低脂饮食,观察组在对照组基础上予清肝化瘀方,每日1剂,每日2次,口服。2组均连续治疗8周。比较2组临床疗效,观察2组治疗前后中医症状积分,血浆降钙素基因相关肽(CGRP)、内毒素、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CPR)、总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)及凝血酶原时间、凝血酶原活动度。结果观察组总有效率为84.09%(37/44),高于对照组的65.12%(29/43),病死率低于对照组,差异有统计学意义(P<0.05)。与本组治疗前比较,2组治疗后中医症状积分明显下降(P<0.05);2组治疗后比较,观察组中医症状积分明显低于对照组(P<0.05)。与本组治疗前比较,2组治疗后CGRP、内毒素、IL-6、hs-CPR、TBIL、ALT、AST水平降低,凝血酶原时间、凝血酶原活动度升高,差异有统计学意义(P<0.05);2组治疗后比较,观察组上述指标改善均优于对照组(P<0.05)。结论清肝化瘀方联合西医常规疗法治疗慢性重型肝炎湿热瘀血证临床疗效显著,可有效减轻患者炎症反应,改善生化指标及凝血功能。

Clinical Study on Qinggan Huayu Decoction Combined with Western Routine Therapy for Treatment of Chronic Severe Hepatitis

Objective To explore the clinical efficacy of Qinggan Huayu Decoction combined with Western routine therapy for the treatment of patients with chronic severe hepatitis(damp-heat and blood-stasis syndrome);To observe its effects on inflammatory indicators,biochemical indicators,and coagulation function.Methods Totally 87 patients were divided into observation group(44 cases)and control group(43 cases)by random number table method.The control group was treated with Western routine medicine and low-fat diet,while observation group received Qinggan Huayu Decoction on the basis of the control group,one dosage per day,twice a day,orally.Both groups were treated continuously for 8 weeks.The clinical efficacy of the two groups was compared.The TCM symptom scores,plasma calcitonin gene-related peptide(CGRP),endotoxin,interleukin-6(IL-6),hypersensitive C-reactive protein(hs-CPR),total bilirubin(TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST),prothrombin time,and prothrombin activity were observed before and after treatment.Results The total effective rate of the observation group was 84.09%(37/44),which was higher than that of the control group 65.12%(29/43).The mortality rate of observation group was lower than that of the control group,with statistical significance(P<0.05).Compared with before treatment,the TCM symptom scores in the two groups significantly decreased(P<0.05);After treatment,the TCM symptom scores in the observation group were significantly lower than the control group(P<0.05).Compared with before treatment,the levels of CGRP,endotoxin,IL-6,hs-CPR,TBIL,ALT and AST decreased,while prothrombin time and prothrombin activity increased in the two groups,with statistical significance(P<0.05).After the treatment,the improvement of the above indicators in the observation group was better than the control group(P<0.05).Conclusion Qinggan Huayu Decoction combined with Western routine therapy has obvious clinical efficacy for the treatment of chronic severe hepatitis(damp-heat and blood-stasis syndrome),which can effectively alleviate inflammatory response,and improve biochemical indicators and blood coagulation function.