目的 評價九味柔肝顆粒治療慢性乙型肝炎肝纖維化(氣滯血瘀兼濕熱未凈證)的療效和安全性.
方法 根據本研究的納入與排除標準,選取慢性乙型肝炎肝纖維化(氣滯血瘀兼濕熱未凈證)患者46例,隨機分為兩組,進行隨機雙盲雙模擬對照試驗.試驗組23例,口服九味柔肝顆粒,每日2次,每次10 g;陽性對照藥鱉甲軟肝片組(對照組)23例,口服鱉甲軟肝片,每日3次,每次4片.療程均為半年.
結果 試驗組完成治療21例,對照組完成22例.就中醫證候療效而言,意向性治療(ITT)分析結果顯示,試驗組總有效率82.61%(19/23),對照組總有效率86.96%(20/23);符合方案數據分析(PP)結果顯示,試驗組總有效率90.48%(19/21),對照組總有效率86.36%(19/22),兩組中醫證候療效比較無統計學意義(P>0.05).就肝纖維化的改善(PP人群)而言,試驗組透明質酸(HA)、Ⅲ型前膠原(PCⅢ)、Ⅳ型膠原(CⅣ)和層粘連蛋白(LN)的總有效率分別為28.57%(6/21)、23.81%(5/21)、28.57%(6/21)和4.76%(1/21);對照組HA、 PCⅢ、CⅣ、和 LN的總有效率分別為36.37%(8/22)、13.64%(3/22)、36.37%(8/22)和 9.09%(2/22),兩組肝纖維化改善的檢測指標比較無顯著性差異(P>0.05),其ITT分析與PP分析結果一致.臨床觀察中未發現明顯不良反應.
結論 九味柔肝顆粒能明顯改善慢性肝炎肝纖維化患者的癥狀,其療效與鱉甲軟肝片相當,未發現明顯的毒副作用.
引用本文:
王麗春,雷秉鈞,劉麗,劉聰,張瑞明,李廷謙. 九味柔肝顆粒治療慢性乙型肝炎肝纖維化的隨機雙盲雙模擬對照試驗. 中國循證醫學雜志, 2004, 04(11): 778-782. doi:
復制
1. |
[1]Yao ZP, Huang WH, Luo XM. Clinical effect of Ruangan pill on hepatitis and cirrhosis[J]. Clinical Journal of Liver and Gall Disease, 1999; 15(3): 187-189.
|
2. |
姚作平, 黃維恒, 羅辛卯. 軟肝丸治療肝炎肝硬化臨床觀察[J]. 臨床肝膽病雜志, 1999; 15(3): 187~189.
|
3. |
[2]Yao ZM, Lu KY, Zhao QY. Experimental study of Biejia fried pill to treat liver fibrosis[J]. Journal of Zhejiang College of traditional medicine, 1997; 21(1): 45-47.
|
4. |
姚真敏, 呂奎源, 趙洽友. 鱉甲煎丸抗肝纖維化作用的實驗研究[J]. 浙江中醫學院學報, 1997; 21(1): 45~47.
|
5. |
[3]Program of prevention and cure of viral hepatitis[J]. Chinese Journal of Hepatic Disease, 2000; 8(6): 324-329.
|
6. |
病毒性肝炎防治方案[J]. 中華肝臟病雜志, 2000; 8(6): 324~329.
|
7. |
[4]Su BH, Chief-editor. New insights of statistics for clinical trials of new drugs[M]. 2nd editon.Shanghai: Publishing House of Science, Technology and Literrature,1999; 43-44.
|
8. |
蘇炳華主編. 新藥臨床試驗統計新進展[M]. 第2版. 上海: 上海科技文獻出版社, 1999; 43~44.
|
9. |
[5]Okazaki I, Watanabe, T, Hozawa S. Reversibility of hepatic fibrosis: from the first report of collagenase in the liver to the possibility of gene therapy for recovery [J]. Keio J Med, 2001; 50(2): 58-65.
|
10. |
[6]Cheng SQ, Zhang ZF, Zhao YW. Research of diagnostic value of collaborated examination of HA, PLD, PCⅢ, LN and CⅣ[J].Chinese Journal of Practical Internal Medicine, 1999; 19(1): 2830.
|
11. |
程書權, 張自富, 趙永偉. 血清HA、PLD、PCⅢ、LN、CⅣ聯合檢測對慢性肝病的診斷價值探討[J]. 中國實用內科雜志, 1999; 19(1): 28~30.
|
12. |
[7]Liu RC, Liu LX, Zhang DY, etc. Relation of serum content of HA, LN, CⅣ, PCⅢ and grade of inflammation and fibrosis of chronic hepatitis[J]. Chinese Journal of Infectious Disease, 1999; 17(2): 122123.
|
13. |
劉仁才, 劉龍秀, 張德遠等. 血清HA、LN、CⅣ、PCⅢ含量與慢性肝炎炎癥活動度及纖維化程度的關系[J]. 中國傳染病雜志, 1999; 17(2): 122~123.
|
- 1. [1]Yao ZP, Huang WH, Luo XM. Clinical effect of Ruangan pill on hepatitis and cirrhosis[J]. Clinical Journal of Liver and Gall Disease, 1999; 15(3): 187-189.
- 2. 姚作平, 黃維恒, 羅辛卯. 軟肝丸治療肝炎肝硬化臨床觀察[J]. 臨床肝膽病雜志, 1999; 15(3): 187~189.
- 3. [2]Yao ZM, Lu KY, Zhao QY. Experimental study of Biejia fried pill to treat liver fibrosis[J]. Journal of Zhejiang College of traditional medicine, 1997; 21(1): 45-47.
- 4. 姚真敏, 呂奎源, 趙洽友. 鱉甲煎丸抗肝纖維化作用的實驗研究[J]. 浙江中醫學院學報, 1997; 21(1): 45~47.
- 5. [3]Program of prevention and cure of viral hepatitis[J]. Chinese Journal of Hepatic Disease, 2000; 8(6): 324-329.
- 6. 病毒性肝炎防治方案[J]. 中華肝臟病雜志, 2000; 8(6): 324~329.
- 7. [4]Su BH, Chief-editor. New insights of statistics for clinical trials of new drugs[M]. 2nd editon.Shanghai: Publishing House of Science, Technology and Literrature,1999; 43-44.
- 8. 蘇炳華主編. 新藥臨床試驗統計新進展[M]. 第2版. 上海: 上海科技文獻出版社, 1999; 43~44.
- 9. [5]Okazaki I, Watanabe, T, Hozawa S. Reversibility of hepatic fibrosis: from the first report of collagenase in the liver to the possibility of gene therapy for recovery [J]. Keio J Med, 2001; 50(2): 58-65.
- 10. [6]Cheng SQ, Zhang ZF, Zhao YW. Research of diagnostic value of collaborated examination of HA, PLD, PCⅢ, LN and CⅣ[J].Chinese Journal of Practical Internal Medicine, 1999; 19(1): 2830.
- 11. 程書權, 張自富, 趙永偉. 血清HA、PLD、PCⅢ、LN、CⅣ聯合檢測對慢性肝病的診斷價值探討[J]. 中國實用內科雜志, 1999; 19(1): 28~30.
- 12. [7]Liu RC, Liu LX, Zhang DY, etc. Relation of serum content of HA, LN, CⅣ, PCⅢ and grade of inflammation and fibrosis of chronic hepatitis[J]. Chinese Journal of Infectious Disease, 1999; 17(2): 122123.
- 13. 劉仁才, 劉龍秀, 張德遠等. 血清HA、LN、CⅣ、PCⅢ含量與慢性肝炎炎癥活動度及纖維化程度的關系[J]. 中國傳染病雜志, 1999; 17(2): 122~123.