丹黄汤治疗慢性乙型肝炎肝纤维化的临床研究  

Clinical Study on Compound Decoction of Radix Salviae Milltorrhizae, Radix Astragali and Rhubarb Against Hepatic Fibrosis in Chronic HBV Patients

作　　者：黄团新[1] 吴淑坤[1] 宋仕玲[1] 李靖[1] 朱艳[1] 

机构地区：[1]武警湖北总队医院内三科,湖北武汉430061

出　　处：《临床军医杂志》2007年第3期361-364,共4页Clinical Journal of Medical Officers

摘　　要：目的观察中药丹黄汤(丹参、黄芪、大黄)抗慢性乙肝肝纤维化的疗效。方法将179名慢性乙肝患者随机分为4组:Ⅰ组50例;Ⅱ组49例,Ⅲ组40例,Ⅳ组40例。Ⅰ组服用丹黄汤;Ⅱ组肌注IFNα-2b;Ⅲ组服用复方丹参滴丸;Ⅳ组为对照组,按常规给予护肝降酶治疗。疗程均为3个月。常规检测肝功能,放射免疫方法检测透明质酸(HA)、Ⅲ型前胶原肽(PCⅢ)、Ⅳ型胶原(Ⅳ-C)和层黏蛋白(LN)等血清肝纤维化指标,彩色多普勒检查肝脾形态、门静脉主干(Dpv)、脾静脉内径(Dsv)、门静脉血流速度(Vpv)和脾厚度(st)等肝纤维化相关血流动力学指标。结果治疗3月后,各组肝功能较治疗前均有明显改善,但治疗组与对照组比较无显著差别;各组血清纤维化指标(LN,PCⅢ,HA和Ⅳ-C)较治疗前均有显著下降,治疗组与对照组比较,有显著性差异(P<0.01),其中,Ⅰ组的作用优于Ⅱ,Ⅲ组(P<0.01),停药6月后仍优于Ⅲ组(P<0.01),对LN,HA和Ⅳ-C的作用优于Ⅱ组(P<0.05);彩色多普勒观察发现,各组对肝脾形态和肝纤维化相关血流动力学指标的作用较治疗前均有改善,Ⅰ组、Ⅱ组的效果相当,明显强于对照组(Ⅳ组),Ⅰ组对Dpv和st的作用强于Ⅲ组(P<0.05),停药6个月后,Ⅰ组药物对Dpv和Vpv的影响仍可保持。结论中药丹黄汤能有效地改善肝功能,减轻肝纤维化程度,且疗效稳定、持久。Objective To explore the effects of the decoction of radix salviae milltorrhizae, radix astragali and rhubarb （DRRR） on hepatic fibrosis in chronic HBV patients. Methods A total of 179 patients with chronic HBV were divided into four groups at random： Group A was treated with DRRR, Group B with IFN-α2b, Group C with complex prescription of red-rooted salvia pills, and Group D with routine drugs as control. Their effects were assessed by fiver function test. The indexes of serum fibrosis, such as hyaluronic acid （HA）, Laminin （LN）, type Ⅲ procollagen （PCⅢ） and type Ⅳ collagen （Ⅳ-C）, were detected with radioimmunoassay, and that of hemodynamics associated with hepatic fibrosis （Dpv, Vpv, Dsv, st） were detected by color Doppler. Results After the treatment of three months, the indexes of liver function were improved without a statistical difference between any of the former three groups and the control group, but that of serum fibrosis （ HA, LN, PC Ⅲ and Ⅳ-C） of the former three group were considerably attenuated when compared with that of the control group （ P 〈 0.01 ）. The indexes of hemodynamics associated with hepatic fibrosis in the former three groups were significantly improved （ P 〈 0.05）. Compared with that of the control group, HA, LN, PC Ⅲ, Ⅳ-C, Dpv, Vpv, Dsv and st were significantly different. Furthermore, the effect of Group A on the above serum fibrosis markers was more significant than any of the other groups （ P 〈 0.05 ）, and the effect of Group A on Dpv, Vpv, Dsv and st was similar to that of Group B. During the six months＇ follow-up after therapy, effect of Group A on Dpv and Vpv was lasting and stable. Conclusion DRRR can effectively improve the fiver function and diminish the hepatic fibrosis in the patients with with chronic HBV, and its efficacy is lasting and stable.

关 键 词：丹黄汤 肝纤维化 血清肝纤维化指标 肝纤维化相关血流动力学指标 

分 类 号：R575.2[医药卫生—消化系统]