软肝丸联合辨证分型治疗乙肝肝硬变
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摘要
目的:采用真实世界研究的方法观察应用软肝丸联合辨证分型对乙型病毒性肝炎(简称乙肝)肝硬变患者肝储备功能和门脉高压症的影响。方法:319例乙肝肝硬变患者随机分为软肝丸联合辨证分型组(联合治疗组) 248例,软肝丸组71例。各组分别给予软肝丸联合辨证其他中药、软肝丸口服,两组均采用核苷酸类似物抗病毒治疗。治疗1年后,比较两组患者血清白蛋白、胆碱酯酶、门静脉内径及流速、脾脏大小等,每3个月检查1次。结果:与治疗前比较,联合治疗组、软肝丸组均能提高乙肝肝硬变患者血清白蛋白和胆碱酯酶水平,降低门脉内径,提高门脉流速,缩小脾脏,差异均有统计学意义(P <0. 05);且联合治疗组以上指标改善更加明显,差异均有统计学意义(P <0. 05)。结论:联合治疗组、软肝丸组均可在一定程度上改善乙肝肝硬变患者肝脏储备功能,降低门脉高压症,且联合治疗组优于软肝丸组。
Objective: To observe the effect of Ruangan Pill combined with syndrome differentiation typing on liver reserve function and portal hypertension in patients with Hepatitis B virus hepatitis( hepatitis B) cirrhosis by real world research( RWR) method.Methods: 319 patients with hepatitis B cirrhosis were randomly divided into Ruangan pill combined with syndrome differentiation typing group( combined treatment group,248 cases) and Ruangan pill group( 71 cases). Each group was given Ruangan pill combined with traditional Chinese medicine based on syndrome differentiation and Ruangan pill orally. Both groups were treated with nucleotide analogue antiviral therapy. After one year of treatment,the serum albumin,cholinesterase,portal vein diameter,flow rate and spleen size were compared between the two groups,and checked every three months. Results: Compared with before treatment,the combined treatment group and Ruangan pill group could increase the serum albumin and cholinesterase levels,reduce the diameter of portal vein,increase the velocity of portal vein and reduce the spleen,and the difference was statistically significant( P <0. 05); the above indexes in the combined treatment group were improved more significantly,and the difference was statistically significant( P < 0. 05). Conclusion: The combined treatment group and Ruangan pill group can improve liver reserve function and reduce portal hypertension in patients with hepatitis B cirrhosis to a certain extent,and the combined treatment group is better than Ruangan pill group.
Objective: To observe the effect of Ruangan Pill combined with syndrome differentiation typing on liver reserve function and portal hypertension in patients with Hepatitis B virus hepatitis( hepatitis B) cirrhosis by real world research( RWR) method.Methods: 319 patients with hepatitis B cirrhosis were randomly divided into Ruangan pill combined with syndrome differentiation typing group( combined treatment group,248 cases) and Ruangan pill group( 71 cases). Each group was given Ruangan pill combined with traditional Chinese medicine based on syndrome differentiation and Ruangan pill orally. Both groups were treated with nucleotide analogue antiviral therapy. After one year of treatment,the serum albumin,cholinesterase,portal vein diameter,flow rate and spleen size were compared between the two groups,and checked every three months. Results: Compared with before treatment,the combined treatment group and Ruangan pill group could increase the serum albumin and cholinesterase levels,reduce the diameter of portal vein,increase the velocity of portal vein and reduce the spleen,and the difference was statistically significant( P <0. 05); the above indexes in the combined treatment group were improved more significantly,and the difference was statistically significant( P < 0. 05). Conclusion: The combined treatment group and Ruangan pill group can improve liver reserve function and reduce portal hypertension in patients with hepatitis B cirrhosis to a certain extent,and the combined treatment group is better than Ruangan pill group.
引文
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[3]马素平.赵文霞教授基于“毒瘀痰虚”理论治疗肝炎肝硬变经验[J].中医研究,2015,28(11):43-46.
[4]王琦.论中医体质研究的3个关键问题(下)[J].中医杂志,2006,47(5):329-332.
[5]唐尹萍,刘焱文.鳖甲研究概况[J].中国药师,2010,30(3):423-425.
[6]姜宏伟.单味鳖甲治疗肝炎肝硬变30例[J].临床医学,2007,17(6):93-94.
[7]杜沛霖,周雨晴,朱华.龟甲的研究进展[J].安徽农业科学,2014,42(32):11319-11320.
[8]刘双,郭珊珊,彭建军,等.穿山甲药用价值概况及临床应用研究综述[J].林业科技通讯,2016,20(7):57-60.
[9]李曦,张丽宏,王晓晓,等.当归化学成分及药理作用研究进展[J].中药材,2013,36(6):1023-1028.
[10]张博.牡蛎提取物对大鼠酒精性肝病的抗脂质过氧化作用研究[D].青岛:青岛大学,2010.
[11]王玉清.桃仁提取物抗肝纤维化作用及其分子机制研究[J].医学理论与实践,2014,27(15):2015-2016.
[12]郑雁,苗明三.鸡内金的现代研究特点分析[J].中医学报,2015,30(12):1796-1797.
[13]马素平,冀爱英.软肝丸治疗肝硬变40例[J].山东中医杂志,2005,24(4):210.
[14]赵义红,胡培森,冀爱英.软肝丸治疗肝硬变30例临床观察[J].亚太传统医药,2011,7(1):49-50.
[15]李敏,时景璞,于慧会.真实世界研究与随机对照试验、单病例随机对照试验在临床诊疗性研究中的关系比较[J].中华流行病学杂志,2012,33(3):342-345.
[16]刘保延.真实世界的中医临床科研范式[J].中医杂志,2013,54(6):451-455.
[17]邓小川,刘建忠,盛国光,等.研究型门诊构建模式探索[J].世界科学技术---中医药现代化,2013,15(5):1140-1142.