中西医结合治疗方案对慢性乙型肝炎抗肝纤维化临床探究.docVIP

中西医结合治疗方案对慢性乙型肝炎抗肝纤维化临床探究【摘 要】目的：通过对中西医结合方案的临床观察，探讨其抗肝纤维化的疗效。方法：通过单盲、随机、对照研究，86N慢性乙型肝炎患者被随机分配到试验组和对照组，进行为期24周的治疗，52试验组患者以拉米夫定加中药健脾活血方药治疗，34名对照组患者以拉米夫定治疗，观察治疗24周后测定肝纤以及免疫指标。结果：试验组的总有效率84.61%，显效率26.92%；对照组为总有效率70.59%，显效率20.59%，有显著性差异。结论：中西医结合治疗方案能通过调节细胞免疫功能，明显改善慢性乙型肝炎患者肝纤指标，起到抗纤维化的作用。 【关键词】慢性乙型肝炎 肝纤维化 中西医结合疗 Clinical Study on Anti-hepatic Fibrosis Effect of patients with chronic hepatitis B of ter integration of Chinese and western medicines FAN Dongmei，et al 【Abstract】Objective：To observe the therapeutic effect of integration of Chinese and western medicines in resisting liver fibrosis of patients of chronic hepatitis B by clinical observation.Methods：In the single-blind，comparative procedure，86 patients with CHB were randomly divided into two groups(test group and control group)for 24 weeks treatment.52 patients of test group were treated with lamivudine and Chinese drug prescription(for strengthening the spleen，replenishing qi，and promoting blood circulation to remove stagnancyl and 34 patients of control group were treated with lamivudine.after 24 weeks of treatment，HF and immunityt tests were measured.Results：The significant effective rate and the total effective rate of the test group were 26.92%and 84.61%respectively.The significant effective rate and the total effective rate of the control group were 20.59%and 70.59%respectivelyThere were significant differences between two groups(P0.05)，具有可比性。 2.2 给药方法。对照组：口服拉米夫定片剂，100mg/片，每日一片口服。试验组：在按对照组方法服用拉米夫定的基础上，口服我院名老中医邓铁涛教授在临床实践的过程中逐渐摸索出的有效处方健脾活血方(太子参30g、白术15g、云苓15g、川萆?10g、炒鳖甲30g、土虫(研末冲服)3g、丹参18g、楮实子12g、菟丝子12g)治疗。观察期间不服用保肝及其他抗病毒肝炎治疗药物，因特殊原因需服用其他药物时给予记录。 2.3 观察指标。 2.3.1 症状、体征。 2.3.2 实验室指标：纤维化指标：Ⅲ型胶原、Ⅳ型胶原、层粘连蛋白(LN)、透明质酸酶(HA)等，治疗前、后各检查1次。免疫指标：IgG、IgM、IgA、CD3+、CD4+、CD8+、CD4+/CD8+，治疗前、后各检查1次。 2.4 疗程24周。 2.5 疗效评定标准。纤维化指标疗效评定标准：参见2000年西安全国传染病与寄生虫病学术会议修订的判定标准。显效：主要血清肝纤维化指标(HA)治疗后较治疗前下降60%以上，或未达此标准，而Ⅳ-c、PCⅢ、LN三项中有两项较治疗前下降60%。有效：HA治疗后较治疗前下降40%以上，或Ⅳ-C、PCⅢ、LN三项中有两项较治疗前下降40%。无效：未达上述标准者。 2.6 统计学处理