| Object:To observe the clinical efficacy of Modified Joint Council Xiaoyaosan Combined with UDCA in chronic hepatitis B and liver cirrhosis associated with refractory jaundice (liver and spleen deficiency), and observed the treatment mechanism of the joint priorities of addition and subtraction Xiaoyaosan and UDCA from two aspects of clinical research and theory.Method:1. The patients were 2010.02-2011.03 Chinese Medicine Hospital in Wuhan during the gastroenterology clinic patients, in line with the Chinese Medical Association in 2005 and the Chinese Medicine Hepatology Infectious Diseases credits will be developed "chronic hepatitis B prevention and control guidelines "diagnostic criteria. Choose chronic hepatitis B and liver cirrhosis, consistent with traditional Chinese medicine TCM xin Huang patients with liver and spleen deficiency, the liver, reducing enx yme, jaundice and other comprehensive treatment, rehabilitation of basic normal AkT liver function, but still higher TBIL (TBIL:20μmol/L-80μmol/L), repeated abnormal past six months 62 patients were randomly divided into two groups. Treatment of 31 patients,31 patients in control group. Two groups of age, gender, disease compared with no significant difference, with comparable (P> 0.05).2. Two groups were given UDCA therapy, the higher liver transaminase plus five capsules, HBV DNA positive to anti-viral therapy with conventional anti-viral treatment, with ascites is appropriate, given the line of furosemide and spironolactone treatment benefit. The treatment group on the basis of the above plus the Council Xiaoyaosan Treating. The treatment lasted 4 weeks. The two groups during the treatment of patients not taking other drugs than the drugs outside.3. Observed adverse reactions to safety evaluation; treatment of clinical symptoms before and after record time, TBIL, ALT treatment under the appropriate standard to evaluate efficacy.Results:1. The total effect:After 4 weeks of treatment, the application of combination therapy group 31 cases,11 cases markedly effective in 13 cases, 7 cases, total effective rate 77.42%; the control group 31 cases, effective in 6 cases,10 cases,15 cases ineffective, the total 51.61% efficiency. Two sets of statistical analysis, the total effective rate in treatment group than the control group was effective (P<0.05), shows that the total effect of treatment group than the control group.2. Total score of clinical symptoms:Total score after treatment compared clinical symptoms before treatment were significantly different (P<0.01); the treatment group and control group total score of clinical symptoms compared to treatment group was significantly better than the control group (P<0.05).3. Before and after treatment TBIL, ALT changes in comparison:①. TBIL After treatment than before treatment were significantly different (P<0.01), the control group after treatment than before treatment TBIL there were significant difference (P<0.05); the two groups after treatment than before treatment were ALT were significantly different (P<0.05);②. the two groups after treatment, the treatment group than in the control group TBIL significant difference (P<0.05); but There were no significant differences in ALT (P> 0.05). In summary, both groups showed significant improvement in liver function, reduce TBIL, ALT, but the treatment group was significantly lower in patients than the control group TBIL aspects, and in reducing ALT, the two groups similar.Conclusion:Clinical studies have shown that through this group, the Council Xiaoyaosan Modified treatment of chronic hepatitis B combined UDCA and liver cirrhosis associated with refractory jaundice (liver depression and spleen type), clinical efficacy was better than the use of UDCA treatment of this disease; showed significant improvement in both groups of patients with liver function, reduce TBIL, ALT, but the treatment group was significantly lower in patients than the control group TBIL areas, and in reducing ALT, the two groups similar. I believe that Xiaoyaosan Decoction combined UDCA treatment and the following aspects:①. UDCA choleretic for strong medicine, jaundice subsided quickly in order to reduce intrahepatic cholestasis, and can give patients to continue treatment confidence. UDCA still protect the liver cell membrane, inhibit liver cell apoptosis, regulation of immune and so on, can protect the liver cells and improve the immune system in elderly patients, can promote the recovery of the disease and reduce complications.②. The Council can only liver and spleen Modified Xiaoyaosan, clearing away heat and jaundice, cooling the blood circulation, both dampness, blood stasis, heat the evil, the positive blood can help to avoid cured evil and injury of blood gas consumption, are imaginary evil love, lingering illness refractory to fundamentally solve the problem, meet the "urgent the symptoms, slow the disease", "cure the disease of the" means.③. Modern research shows that the Bureau Xiaoyaosan addition and subtraction, and UDCA treatment in such a synergistic effect of jaundice. |
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