【摘要】 目的观察西医联合中医活血化瘀法治疗肝硬化的临床效果。方法应用随机数字表法将深圳市第三人民医院中医内科和深圳市中医医院内科2013年10月至2015年9月期间收治的148例肝硬化患者分为中西医结合组和西医组,各74例,西医组实施西医常规治疗,中西医结合组在西医组治疗基础上加用活血化瘀中药方剂,持续用药3个月。比较两组患者的主要临床症状体征、肝功能指标及肝纤维化指标变化。结果中西医结合组患者治疗后的纳差[(1.31±0.17)分]、乏力[(1.06±0.13)分]、腹胀[(1.11±0.19)分]、目黄[(0.84±0.20)分]、腹痛[(0.44±0.10)分]症状评分均明显低于西医组[(1.31±0.17)分,(1.06±0.13)分,(1.11±0.19)分,(0.84±0.20)分,(0.44±0.10)分],差异均有统计学意义(P<0.05);中西医结合组患者治疗后的透明质酸酶(HA)[(76.50±33.1)ng/L]、Ⅲ型前胶原蛋白(PC-Ⅲ)[(50.5±33.4)ng/L]、Ⅳ型胶原蛋白(Ⅳ-C)[(69.9±13.1)ng/L]、层黏蛋白(LN)[(69.9±13.1)ng/L]水平均明显高于西医组[(124.32±55.4)ng/L、(71.7±42.9)ng/L、(99.7±15.6)ng/L、(127.6±57.6)ng/L],差异均有统计学意义(P<0.05);中西医结合组患者治疗后的谷丙转氨酶(ALT)[(90.03±102.8)U/L]、谷草转氨酶(AST)[(103.12±101.3)U/L]、总胆红素(TBi L)[(53.4±30.4)μmol/L]水平均明显低于西医组[(136.42±120.8)U/L、(157.72±124.3)U/L、(73.52±36.8)μmol/L],胆红素(ALB)水平明显高于西医组[(38.73±5.5)g/L vs(35.30±5.4)g/L],差异均有统计学意义(P<0.05)。结论西医联合中医活血化瘀法治疗肝硬化能有效减轻临床症状及体征,改善肝功能,提高临床疗效,是一种安全、有效的治疗方案。更多还原

【Abstract】 Objective To observe the clinical effect of western medicine combined with traditional Chinese medicine on promoting blood circulation to remove blood stasis in the treatment of liver cirrhosis.Methods A total of148 cases of patients with liver cirrhosis,who admitted to the Department of Internal Medicine of Shenzhen Third People’s Hospital Affiliated to Guangdong Medical College and Department of Internal Medicine of Shenzhen Chinese Medicine Hospital during October 2013 to September 2015,were divided into the traditional Chinese medicine combined with western medicine group(combined group) and the western medicine group according to the random number table method,with 74 cases in each group.The western medicine group was treated by implementation of conventional western medicine treatment,and the combined group was treated with additional Huoxue Huayu Prescription of traditional Chinese medicine.The two groups continued drug use for 3 months.The main clinical symptoms and signs,liver function indexes and liver fibrosis indexes of the two groups were compared.Results After 3 months of treatment,the anorexia [(1.31 ± 0.17)],fatigue [(1.06 ± 0.13)],abdominal distention [(1.11 ± 0.19)],yellow eyes [(0.84 ± 0.20)],abdominal pain [(0.44 ± 0.10)] symptoms score of combined group were significantly lower than those of western medicine group[(1.31±0.17),(1.06±0.13),(1.11±0.19),(0.84±0.20),(0.44±0.10),P<0.05];Hyaluronidase(HA) [(76.50±33.1) ng/L],typeⅢprocollagen(PC-Ⅲ) [(50.5±33.4) ng/L],type Ⅳ collagen(Ⅳ-C) [(69.9±13.1) ng/L],laminin(LN) [(69.9±13.1) ng/L]levels in the combined group were significantly higher than those in the western medicine group [(124.32±55.4) ng/L,(71.7±42.9) ng/L,(99.7±15.6) ng/L,(127.6±57.6) ng/L,P<0.05];Alanine transaminase(ALT) [(90.03±102.8) U/L],aspartate aminotransferase(AST) [(103.12 ± 101.3) U/L],total bilirubin(TBIL) [(53.4 ± 30.4) μ mol/L] in the combined group were significantly lower than these in the western medicine group [(136.42 ± 120.8) U/L,(157.72 ± 124.3) U/L,(73.52±36.8) μmol/L],and bilirubin(ALB) level in the combined group was significantly higher than those in the control group [(38.73±5.5) g/L vs(35.30±5.4) g/L,P<0.05].Conclusion In the treatment of liver cirrhosis,western medicine combined with traditional Chinese medicine can effectively reduce clinical symptoms and signs,improve liver function and clinical efficacy,which is a safe and effective treatment solution.更多还原