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[目的]观察疏肝化瘀汤联合西药治疗肝郁血瘀肝纤维化疗效。[方法]使用随机平行对照方法,将60例住院及门诊患者按就诊顺序号方法简单随机分两组;根据不同病情,恩替卡韦抗病毒,甘草酸二铵,还原型谷胱甘肽,茵栀黄等保肝降酶退黄;螺内酯,呋噻米利尿及对症治疗。对照组30例复方鳖甲软肝片,4片/次,3次/d。治疗组29例疏肝化瘀汤(柴胡12g,当归15g,赤白芍、炒白术、丹参、鳖甲~(捣碎先煎)各15g、土鳖虫10g,黄芪15g,桃仁10g,炙甘草6g,随证加减),1剂/d,水煎150mL,早晚口服。连续治疗6个月为1疗程。观测临床症状、症状积分、肝功能、肝纤四项、门静脉内径、脾静脉内径、脾脏厚度、肝脏硬度、不良反应。治疗1疗程,判定疗效。[结果]治疗组临床痊愈18例,有效9例,无效2例,总有效率93.10%;对照组临床痊愈12例,有效8例,无效10例,总有效率66.67%;治疗组疗效优于对照组(P<0.05)。症状积分、ALT、AST、TBil、ALB、PCIII、LN、HA、IV-C、肝脏硬度改善治疗组优于对照组(P<0.01)。[结论]疏肝化瘀汤联合西药治疗肝郁血瘀肝纤维化,疗效满意,无严重不良反应,值得推广。
[Objective] To observe the curative effect of Shugan Huayu decoction combined with Western medicine on liver fibrosis with liver-qi stagnation and blood stasis. [Methods] Using randomized parallel control method, 60 inpatients and outpatients were randomly divided into two groups according to the sequence number of attending clinic. According to the different conditions, antivirals of entecavir, diammonium glycyrrhizinate, reduced glutathione, Liver and other anti-yellowing enzyme; spironolactone, furosemide diuretic and symptomatic treatment. Control group, 30 cases of Biejia Rugan, 4 tablets / time, 3 times / d. The treatment group, 29 cases of Shugan Huayu Decoction (Bupleurum 12g, Angelica 15g, red peony root, fried Atractylodes, Salvia, turtle A ~ (mashed Xianxian) the 15g, Eupolyphaga 10g, Astragalus 15g, peach 10g, 6g, with the card addition and subtraction), 1 / d, decoction 150mL, morning and evening oral. Continuous treatment of 6 months for a course of treatment. Clinical symptoms, symptom scores, liver function, four liver fibrosis, portal vein diameter, splenic vein diameter, spleen thickness, liver stiffness and adverse reactions were observed. Treatment of a course of treatment to determine the efficacy. [Results] In the treatment group, 18 cases were cured, 9 cases were effective, 2 cases were ineffective, and the total effective rate was 93.10%. In the control group, 12 cases were cured, 8 cases were effective and 10 cases were ineffective. The total effective rate was 66.67% Control group (P <0.05). Symptom score, ALT, AST, TBil, ALB, PCIII, LN, HA, IV-C, liver stiffness improvement in the treatment group were better than those in the control group (P <0.01). [Conclusion] Shugan Huayu Decoction combined with western medicine can treat liver and blood stasis and liver fibrosis with satisfactory results and no serious adverse reactions, which deserves promotion.