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[目的]观察培土益肝汤联合复方鳖甲软肝片与水飞蓟宾治疗肝郁脾虚型代偿期酒精性肝硬化疗效。[方法]使用随机平行对照方法,将72例住院及门诊患者按抛硬币法简单随机分为两组。对照组36例复方鳖甲软肝片,2g/次,3次/d;水飞蓟宾,70mg/次,3次/d。治疗组36例培土益肝汤(党参20g,郁金12g,白术20g,云苓30g,川楝子10g,麦芽、虎杖各20g,三棱、文术各10g,鳖甲炙、白芍各20g,赤芍15g,马鞭草20g,甘草6g;胁痛甚加元胡、田基黄;纳呆加内金、神曲;腹胀甚加枳壳、大腹皮;瘀滞甚加土元、山甲;阴虚加沙参、麦冬、生地;气虚加黄芪、黄精);1剂/d,水煎300m L,早晚口服;西药治疗同对照组。连续治疗6个月为1疗程。观测临床症状、谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷氨酰转肽酶(GGT)、总胆红素(TBIL)、不良反应。治疗1疗程,判定疗效。[结果]临床疗效治疗组疗效优于对照组(P<0.05)。肝功能指标治疗组改善优于对照组(P<0.05)。[结论]培土益肝汤联合复方鳖甲软肝片与水飞蓟宾治疗肝郁脾虚型代偿期酒精性肝硬化,疗效满意,无严重不良反应,值得推广。
[Objective] To observe the curative effect of “Peituyi Yigan Decoction” and “Fufang Biejia Ruangan Tablet” and “Silybin” in the treatment of decompensated alcoholic liver cirrhosis with liver-qi stagnation and spleen deficiency syndrome. [Methods] Using randomized parallel control method, 72 inpatients and outpatients were randomly divided into two groups according to the coin-tossing method. The control group of 36 cases of Fufang Biejia Ruangan tablet, 2g / times, 3 times / d; silybin, 70mg / times, 3 times / d. Treatment group of 36 cases of Zhitui Yi Gan Tang (Codonopsis 20g, turmeric 12g, Atractylodes 20g, Yun Ling 30g, Toosendan 10g, Malt, Polygonum cuspidatum 20g, trigeminal, art of the 10g, turtle scouring, peony root 20g , Red peony root 15g, verbena 20g, licorice 6g; hypochondriac pain plus Yuan Hu, Tian Ji Huang; Admittedly plus Neijin, Divine Comedy; abdominal distension plus Citrus aurantium, large belly skin; ; Radix Ginseng, Radix, habitat; Qi and Astragalus, Polygonatum); 1 / d, decoction 300m L, morning and evening oral; western medicine treatment with the control group. Continuous treatment of 6 months for a course of treatment. Clinical symptoms, ALT, AST, GGT, TBIL and adverse reactions were observed. Treatment of a course of treatment to determine the efficacy. [Results] The curative effect of the clinical curative effect group was better than that of the control group (P <0.05). The improvement of liver function indexes in the treatment group was better than that in the control group (P <0.05). [Conclusion] Peiguat Yigan Decoction combined with Fufang Biejia Ruangan Pian and silybin in the treatment of decompensated alcoholic cirrhosis of liver-qi and spleen deficiency patients has satisfactory curative effect and no serious adverse reactions, which is worthy of popularization.