| 摘要: |
| ［摘要］ 目的 观察加味济生肾气汤联合穴位注射黄芪注射液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。比较两组治疗前后慢性肝病问卷（CLDQ）评分、Child-Turcotte-Pugh（CTP）评分、肝脏硬度测量（LSM）值及血生化指标。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例在治疗期间退出该研究，其中对照组2例，观察组3例。与治疗前比较，两组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）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值、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），对照组白蛋白（ALB）水平显著升高（P<0.05）。治疗后，观察组CLDQ评分显著高于对照组（P<0.05），LSM值及ALT、AST、TBIL、ALB、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穴位注射黄芪注射液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 |
| DOI：10.3969/j.issn.1674-3806.2026.05.07 |
| 分类号:R 259 |
| 基金项目:国家自然科学基金项目（编号：82160882）；广西中医药适宜技术开发与推广项目（编号：GZSY2024077）；柳州市科技计划项目（编号：2024YB0101B013） |
|
| Observation on the clinical effect of modified Jisheng Shenqi Decoction combined with Astragalus injection at acupoints in treatment of viral hepatitis B-related cirrhosis |
|
LI Zepeng1, LIN Jun2, HAN Lu1, YU Junying2, WANG Wenshuai2, WEI Xuelian2, WU Chan2
|
|
1.Department of Infectious Diseases, Liuzhou Traditional Chinese Medical Hospital(the Third Affiliated Hospital of Guangxi University of Chinese Medicine), Liuzhou 545000, China; 2.Graduate School, Guangxi University of Chinese Medicine, Nanning 530000, China
|
| Abstract: |
| ［Abstract］ Objective To observe the clinical effect of modified Jisheng Shenqi Decoction combined with Astragalus injection at acupoints in treatment of viral hepatitis B-related cirrhosis. Methods A total of 94 patients with viral hepatitis B-related cirrhosis who were admitted to Liuzhou Traditional Chinese Medical Hospital from January 2024 to January 2025 were recruited as the research subjects. The patients were divided into control group and observation group by using random number table method, with 47 patients in each group. The control group received conventional medical treatment, while the observation group was given the same treatment as the control group plus modified Jisheng Shenqi Decoction combined with Astragalus injection at acupoints. Both groups were treated continuously for 12 weeks. The Chronic Liver Disease Questionnaire(CLDQ) scores, Child-Turcotte-Pugh(CTP) scores, liver stiffness measurement(LSM) values, and biochemical indicators were compared between the two groups before and after the treatment. The occurrence of adverse reactions during the treatment period in both groups were recorded. Results Among the 94 patients, 5 patients withdrew from the study during the treatment period, including 2 patients in the control group and 3 patients in the observation group. Compared with those before the treatment, the CLDQ scores were significantly increased(P<0.05), and the CTP scores and the levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST) and total bilirubin(TBIL) were significantly decreased(P<0.05) and the prothrombin time(PT) was significantly shortened after the treatment in the two groups(P<0.05). Compared with those before the treatment, the LSM values and the levels of hyaluronic acid(HA), laminin(LN), type Ⅲ procollagen(PC-Ⅲ) and type Ⅳ collagen(Ⅳ-C) were significantly decreased after the treatment in the observation group(P<0.05), while the albumin(ALB) levels were significantly increased after the treatment in the control group(P<0.05). After the treatment, the CLDQ scores in the observation group were significantly higher than those in the control group(P<0.05), while the LSM values and the levels of ALT, AST, TBIL, ALB, HA, LN, PC-Ⅲ and Ⅳ-C in the observation group were significantly lower than those in the control group(P<0.05). During the treatment period, no serious adverse reactions occurred in either group. Conclusion The combination of modified Jisheng Shenqi Decoction with Astragalus injection at acupoints is significantly effective in treating viral hepatitis B-related cirrhosis. The combined treatment can effectively improve the patients′ liver function, reduce the degree of liver fibrosis, and enhance their quality of life. |
| Key words: Jisheng Shenqi Decoction Astragalus injection Acupoint injection Viral hepatitis B Liver cirrhosis |
