八珍汤合化积丸加减联合核苷类药物治疗"正虚血瘀型"乙肝肝硬化继发脾功能亢进的效果OA
Effect of Bazhen Decoction and Huaji Pills Combined with Nucleoside Drugs in the Treatment of"Positive Deficiency and Blood Stasis Type"Hepatitis B Cirrhosis and Secondary Hypersplenism
目的:探讨八珍汤合化积丸加减联合核苷类药物治疗"正虚血瘀型"乙肝肝硬化继发脾功能亢进的效果.方法:选取 2020 年 6-12 月在武威市凉州医院就诊的西医诊断为"乙型肝炎后肝硬化继发脾功能亢进"、中医辨证为"正虚血瘀型"的 96 例患者作为研究对象,根据随机数表法分为对照组和观察组,各 48 例.对照组给予替诺福韦酯,观察组给予替诺福韦酯联合八珍汤合化积丸,比较两组白细胞(WBC)、血小板(PLT),凝血酶原活动度(PTA)、脾脏厚度、门静脉内径变化、肝脏硬度值及临床疗效.结果:治疗前、治疗 3 个月,两组WBC、PLT、PTA水平及脾脏厚度、门静脉内径比较,差异无统计学意义(P>0.05);治疗 6 个月,两组WBC、PLT、PTA水平较治疗前升高,脾脏厚度、门静脉内径较治疗前降低,且观察组优于对照组,差异有统计学意义(P<0.05).两组治疗前肝脏FibroScan弹性值比较,差异无统计学意义(P>0.05);观察组治疗 6 个月肝脏FibroScan值小于对照组,差异有统计学意义(P<0.05).观察组总有效率为 87.5%,高于对照组的 62.5%,差异有统计学意义(P<0.05).结论:八珍汤和化积丸加减联合核苷类药物治疗"正虚血瘀型"乙肝肝硬化继发脾功能亢进,不仅能改善患者的临床症状,还能提高WBC、PLT,改善PTA,在降低肝脏硬度值及脾脏厚度和门静脉内径方面效果显著.
Objective:To explore clinical effect of Bazhen Decoction and Huaji Pills combined with nucleoside drugs in the treatment of"positive deficiency and blood stasis type"hepatitis B cirrhosis and secondary hypersplenism.Method:From June to December 2020,96 patients who diagnosed as"hepatitis B cirrhosis and secondary hypersplenism"by western medicine and"positive deficiency and blood stasis type"by traditional Chinese medicine syndrome differentiation in Wuwei City Liangzhou Hospital were selected as the research objects,they were divided into the control group and the observation group according to the random number table method,48 cases in each group.The control group was given Tenofovir Dipivoxil,and the observation group was given Tenofovir Dipivoxil combined with Bazhen Decoction and Huaji Pills.The white blood cell(WBC),platelet(PLT),prothrombin activity(PTA),spleen thickness,portal vein diameter,liver hardness and clinical efficacy of two groups were compared.Result:Before treatment and 3 months after treatment,there were no significant differences in WBC,PLT,PTA levels,spleen thickness and portal vein diameter between two groups(P>0.05);at 6 months of treatment,the levels of WBC,PLT and PTA in two groups were higher than those before treatment,the spleen thickness and portal vein diameter were lower than those before treatment,and those in the observation group were better than those in the control group,the differences were statistically significant(P<0.05).There was no significant difference in liver FibroScan elasticity value between two groups before treatment(P>0.05);the liver FibroScan elasticity value of the observation group at 6 months of treatment was lower than that of the control group,and the difference was statistically significant(P<0.05).The total effective rate of the observation group was 87.5%,which was higher than 62.5%of the control group,the difference was statistically significant(P<0.05).Conclusion:Bazhen Decoction and Huaji Pills combined with nucleoside drugs in the treatment of"positive deficiency and blood stasis type"hepatitis B cirrhosis and secondary hypersplenism can not only improve the clinical symptoms,but also increase the WBC and PLT,and improve PTA,and have significant effects in reducing the liver hardness value,the thickness of the spleen and the diameter of portal vein.
滕飞
武威市凉州医院 甘肃 武威 733000
八珍汤合化积丸核苷类药物乙肝肝硬化继发性脾功能亢进
Bazhen Decoction and Huaji PillsNucleoside drugsHepatitis B cirrhosisSecondary hypersplenism
《中外医学研究》 2024 (009)
35-39 / 5
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