- 期刊
小柴胡湯配方對慢性肝炎之療效評估
Effectiveness of Sheau-Chair-Hou Tang-based Regimens in the Treatment of Chronic Viral Hepatitis
摘要
目的：國人感染病毒性肝炎比率高，認為中醫，藥性溫和無毒，可長久服用，加上日本民間認為小柴胡湯對治療肝炎有療效。在西醫無有效之治療藥，小柴胡湯被多數人長期服用。熊膽有清熱、袪黃、平肝效果，被民間用來治療肝炎特效藥。但必須從熊內臟，剖腹取膽或從熊體內做一引管取膽汁，誠非人道。世界保護稀有動物呼聲中，大量採取熊膽成為被攻擊目標，本研究擬以豬膽來取代評估其療效。方法：本研究以臺北市立聯合醫院和平院區中西醫聯合肝膽門診的病患為研究對象對慢性肝炎病人分：(A)小柴胡湯加熊膽；(B)小柴胡湯加豬膽；(C)小柴胡湯；(D)辨證論治，四組進行完整三個月中醫治療，治療前後接受一系列肝腎功能生化檢查腹部超音波，若B型肝炎病人加直接偵測血清中B型肝炎病毒的去氧核醣核酸(HBV DNA)的DNA聚合酶連鎖反應熊膽與豬膽在小柴胡湯中對肝炎的療效，測量HBV DNA量的變化。結果：65位完整三個月統計其結果如下：（一）「小柴胡湯加熊膽」對症狀評分有改善，但無統計學的意義，肝功能統計學上有意義的改善；（二）「小柴胡湯加豬膽」對症狀評分稍有改善，肝功能亦有改善下降；（三）「小柴胡湯」對症狀評分有改善卻無統計學意義，對肝功能亦有改善，但無統計之意義；（四）「辨證論治給藥」對肝功能，症狀評分皆有改善且有統計學的意義。結論：由本研究得知中醫對辨證論治治療在臨床上有其存在意義。
並列摘要
Background and Purpose：The ratio of patients with infective hepatitis virus is high in Taiwan. We found there were few or no toxic side effects to taking traditional Chinese medicine herbs long term. The curative effects of Sheau-Chair-Hon Tang for patients with hepatitis are believed among the people of Taiwan and Japan. Many people take the herbal combination long term to treat hepatitis since no good effects were seen after using modern Western medicine. People with hepatitis and jaundice have been treated with xionfdon which is an especially effective drug. However, it is not humane since it is derived by draining the abdomen of a living bear so we hoped to find a drug to use instead of xioufdon with zhrdanzhi. Methods：We evaluated the effectiveness of alternatives under the guidelines of an association for the protection of animals. The aim of this study was unify the outpatient departments of Traditional Chinese Medicine and Western medicine to refer patients with liver and gallbladder diseases in the Heping Hospital in Taipei. A total of 65 patients with liver disease were divided into four groups and were given different drugs. Patients in group (Ⅰ) were given Sheau-Chair-Hou Tang and Xionfdon. Patients in group (Ⅱ) were given Sheau-Chair-Hou Tang and Zhrdanzhi. Patients in group (Ⅲ) were given Sheau-Chair-Hou Tang. Patients in group (Ⅳ) were given differential identification drugs. The blood tests of liver functions were checked before and after 3 months of treatment and we compared the data among the groups. We also detected the DNA molecular changes of the hepatitis virus B with the techniques of polymerase chain reaction. Results: The results included: (1) group Ⅰ. There were no statistically significant differences although the symptoms improved and the liver functions improved. (2) group Ⅱ. There were no statistically significant differences although the symptoms improved and there were a few liver function improvements. (3) group Ⅲ. The results were as the same as those of group Ⅰ. (4) group Ⅳ. There were statistically significant differences in the symptom improvement and improvement of liver functions. Conclusion：We concluded that differential identification was significant in the treatment of the liver disease in the Traditional Chinese medicine clinics.