调肝理脾方治疗酒精性肝纤维化的临床研究.docVIP

???? 调肝理脾方治疗酒精性肝纤维化的临床研究 ???? ???? 摘　要：对30例酒精性肝纤维化患者应用调肝理脾方治疗1个疗程。观察治疗前后临床症状、体征、纤维化血清指标、生化检查、B超检查的变化情况，根据疗效判定标准进行了疗效评价。 结果显示：临床症状、体征获得了明显的改善，治疗前后总体症状积分有显著性差异(P0.01)，中医症状、体征总有效率为89.03%；血清学检测、肝功能检查治疗前后有显著性差异(P0.01)；影像学检查也获得了明显的改善。说明调肝理脾方有明显的改善酒精性肝纤维化患者症状、体征，改善肝功能及逆转肝纤维化的作用。关键词：调肝理脾方；肝纤维化；酒精；临床研究分类号：R575.2 Clinical Study of Tiaoganlipifang on Alcoholic Hepatic Fibrosis Ding Xia,Tian Delu,Yan Xiaoli,et al.(The Affiliated Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine,Beijing 100700) Abstract：A course of treatment was taken on 30 patients.Observe clinical symptoms and physical signs,serological indexes,results of biochemical analysis and B-type ultrasonic diagnosis pre and after treatment.Comparative study was carried on and the treatment was evaluated according to the criterion of therapeutic efficiency.Results: Clinical symptoms and physical signs were improved markedly,total symptoms accumulation had significant difference pre and after treatment,the overall effective rate of TCM symptoms and physical signs was 89.03%.The results of serological examination,liver function test and iconographic examination were all improved markedly.Its proved that Tiaoganlipifang has remarkable efficacy on improving symptoms and physical signs of alcoholic hepatic fibrosis,improving liver function and reversing hepatic fibrosis.KEY WORDS：Tiaoganlipifang; Hepatic fibrosis; Alcoholic; Clinical study▲ 　　随着社会的发展和嗜酒人群的扩大,酒精引起的肝损害不仅严重危害着人类的身体健康,而且成为社会问题的重要内容。酒精性肝损害发展到后期，将形成酒精性肝纤维化和酒精性肝硬化,其预后不良。而且嗜酒者即使知道有肝损害的存在，却也很难彻底戒酒，因此将会使疾病不断发展和演变。酒精性肝纤维化阶段由于其病变尚可逆转，因此是治疗的良好契机。中医学发挥整体调节和三因制宜的特长，在以往的研究中已显示了其优势。调肝理脾方是在临床上应用多年的经验方，以往的临床及实验研究均证实其治疗酒精性肝损害有良好的效果［1］。为了进一步系统而深入地探讨其对酒精性肝纤维化的疗效，故进行了本临床研究，现将临床研究结果报告如下。 1　临床资料 　　观察病例均为东直门医院消化科门诊和住院病人，选择酒精性肝纤维化病人证属肝郁脾虚、血瘀痰阻型为临床观察对象。共观察30例，均为男性，其中住院病人19例，门诊病人11例；年龄在32～60岁之间，平均年龄为49.65岁；体重51～83 kg，平均62.83 kg；持续饮酒时间10～42年，平均20.75年；每日饮酒量150～400 g，平均224.5 g。 2　诊断标准 2．1　西医诊断标准　　参照1994年日本拟定的“酒精性肝损伤诊断标准”及1995年中华医学会在北京制定的病毒性肝炎防治方案（试行）［1］有关标准制