| 引用本文: | 李泽鹏,林 钧,韩露,余君莹,王文帅,韦雪莲,吴婵.加味济生肾气汤联合黄芪注射液穴位注射治疗乙肝肝硬化的临床观察[J].中国临床新医学,0,():-. |
| LI Zepeng,LIN Jun,HAN Lu,YU Junying,WANG Wenshuai,WEI Xuelian,WU Chan.加味济生肾气汤联合黄芪注射液穴位注射治疗乙肝肝硬化的临床观察[J].中国临床新医学,0,():-. |
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| 加味济生肾气汤联合黄芪注射液穴位注射治疗乙肝肝硬化的临床观察 |
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李泽鹏1, 林 钧2, 韩露1, 余君莹2, 王文帅2, 韦雪莲2, 吴婵2
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1.广西中医药大学第三附属医院;2.广西中医药大学
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| 摘要: |
| 目的 观察加味济生肾气汤联合黄芪注射液穴位注射治疗乙型病毒性肝炎肝硬化的临床效果。方法 招募2024年1月至2025年1月柳州市中医医院收治的94例乙型病毒性肝炎肝硬化患者作为研究对象，按照随机数字表法将其分为对照组与观察组，每组各47例。对照组接受常规内科治疗，观察组在对照组的基础上加服加味济生肾气汤配合穴位注射黄芪注射液，两组连续治疗12周。比较两组治疗前后生活质量评分、Child-Turcotte-Pugh（CTP）评分、肝脏硬度测量值（LSM）及生化指标。记录两组治疗期间不良反应发生情况。结果 94例患者中，有5例在治疗期间因各种原因退出本研究，其中对照组2例，观察组3例。与治疗前比较，两组慢性肝病问卷（CLDQ）评分显著上升（P < 0.05），CTP评分及丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、总胆红素（TBIL）、透明质酸（HA）、层粘连蛋白（LN）、Ⅲ型前胶原肽（PC-Ⅲ）、Ⅳ型胶原（Ⅳ-C）水平显著降低（P < 0.05），凝血酶原时间（PT）显著缩短（P < 0.05）。与治疗前比较，观察组LSM显著降低（P < 0.05），对照组白蛋白（ALB）水平显著升高（P < 0.05）。治疗后，观察组的CLDQ评分显著高于对照组（P < 0.05），LSM及ALT、AST、TBIL、HA、LN、PC-Ⅲ、Ⅳ-C水平显著低于对照组（P < 0.05）。治疗期间两组患者未出现严重不良反应。结论 加味济生肾气汤联合黄芪注射液穴位注射治疗乙型病毒性肝炎肝硬化患者疗效显著，能有效改善患者肝功能，减轻肝纤维化程度，提高患者生活质量。 |
| 关键词: 济生肾气汤 黄芪注射液 穴位注射 乙型病毒性肝炎 肝硬化 |
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| 基金项目:国家自然科学基金项目(82160882)；广西中医药适宜技术开发与推广项目(GZSY2024077)；柳州市科技计划项目(2024YB0101B013)；广西中医药大学联合(2024LZ002) |
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| Clinical Observation on Modified Jisheng Shenqi Decoction Combined with Acupoint injection of Astragalus Injection in the Treatment of Compensatory Stage of hepatitis B Cirrhosis |
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LI Zepeng,LIN Jun,HAN Lu,YU Junying,WANG Wenshuai,WEI Xuelian,WU Chan
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The Third Affiliated Hospital of Guangxi University of Chinese Medicine
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| Objective To observe the clinical efficacy of treating viral hepatitis B-related cirrhosis with a combination of Modified Jisheng Shenqi Decoction and acupoint injection of Astragalus membranaceus injection. Methods Between January 2024 and January 2025, a total of 94 patients diagnosed with viral hepatitis B-induced cirrhosis and admitted to Liuzhou Traditional Chinese Medicine Hospital were enrolled as research participants. These patients were randomly assigned to either a control group or an observation group using a random number table method, with each group comprising 47 patients.The control group underwent conventional medical treatment, whereas the observation group received an additional regimen consisting of Modified Jisheng Shenqi Decoction combined with acupoint injections of Astragalus injection, in addition to the treatment given to the control group. Both groups were treated continuously for 12 weeks. Comparisons were made between the two groups regarding quality of life scores, Child-Turcotte-Pugh (CTP) scores, liver stiffness measurements (LSM), and biochemical indicators before and after treatment. Additionally, the incidence of adverse reactions during the treatment period was documented for both groups. Results Out of the 94 patients, five withdrew from the study for various reasons during the treatment period, with two from the control group and three from the observation group. Compared to pre-treatment levels, both groups demonstrated a significant increase in Chronic Liver Disease Questionnaire (CLDQ) scores (P < 0.05), along with notable decreases in Child-Turcotte-Pugh (CTP) scores, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), hyaluronic acid (HA), laminin (LN), type III procollagen peptide (PC-III), and type IV collagen (IV-C) levels (P < 0.05). Additionally, there was a significant reduction in prothrombin time (PT) (P < 0.05). In comparison to pre-treatment values, the observation group exhibited a significant decrease in LSM (P < 0.05), whereas the control group showed a significant increase in albumin (ALB) levels (P < 0.05). After treatment, the observation group had significantly higher CLDQ scores and significantly lower LSM, ALT, AST, TBIL, HA, LN, PC-III, and IV-C levels compared to the control group (P < 0.05). No serious adverse reactions were reported in either group during the treatment period. Conclusion The combined therapy of Modified Jisheng Shenqi Decoction and acupoint injection with Astragalus membranaceus injection has shown remarkable efficacy in treating patients with hepatitis B virus-related cirrhosis, effectively improving liver function, alleviating liver fibrosis, and enhancing patients' quality of life. |
| Key words: Jisheng Shenqi Decoction Astragalus Injection Acupoint injection Hepatitis B virus liver cirrhosis |
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