蒙药清肝九味散治疗酒精性肝纤维化的效果观察  

Clinical effect of Mongolian medicine Qinggan Jiuwei powder in treatment of alcoholic liver fibrosis

作　　者：戈宏焱[1] 张仕华[2] 赵百岁[1] 于传科 

机构地区：[1]内蒙古民族大学附属医院内蒙古民族大学临床医学院消化内科,内蒙古通辽028000 [2]内蒙古民族大学,内蒙古通辽028000 [3]通辽市科尔沁区第一人民医院,内蒙古通辽028000

出　　处：《临床肝胆病杂志》2017年第12期2316-2320,共5页Journal of Clinical Hepatology

基　　金：内蒙古自然科学基金面上项目(2015MS0805)

摘　　要：目的观察蒙药清肝九味散对酒精性肝纤维化患者影像学指标的改善情况,探讨清肝九味散治疗肝纤维化的疗效。方法收集2015年10月-2017年1月期间内蒙古通辽市科尔沁区第一人民医院消化内科病房及门诊就诊的酒精性肝纤维化患者104例,随机分为试验组(n=52)和对照组(n=52)。实验组给予蒙药清肝九味散,对照组给予还原型谷胱甘肽片。收集患者治疗前、后的肝功能指标、肝脾超声检查结果及Fibro Scan检测的肝硬度值(LSM)。符合正态分布的计量资料组间比较采用独立样本t检验,组内比较采用配对样本t检验;非正态分布的计量资料组间比较采用Wilcoxon秩和检验。结果 2组患者临床症状及体征均有不同程度改善,试验组与对照组患者治疗前后ALT、AST、GGT、LSM水平比较差异均有统计学意义(试验组:Z值分别为-3.09、-7.19、-8.27,t=7.13,P值分别0.002、<0.001、<0.001、<0.001;对照组:Z值分别为-3.28、-4.60、-5.06,t=8.54,P值分别为0.001、<0.001、<0.001、<0.001);治疗后试验组与对照组AST、GGT水平比较差异均有统计学意义(Z值分别为-2.02、-2.15,P值分别为0.04、0.03);试验组与对照组患者治疗前后肝右叶斜径、门静脉内径、门静脉速度、脾厚度、脾静脉内径比较差异均有统计学意义(试验组:t值分别为6.48、11.02、2.20、3.30、5.30,P值分别为<0.001、<0.001、0.030、<0.001、<0.001;对照组:t值分别为3.51、6.31、2.68、3.06、4.71,P值分别为0.01、<0.001、0.01、<0.001、<0.001);治疗后2组间肝右叶斜径、门静脉内径比较差异均有统计学(t值分别为3.96、3.53,P值分别为0.02、0.01)。结论蒙药清肝九味散治疗酒精性肝纤维化具有较好的疗效,能够有效改善酒精性肝纤维化患者LSM和腹部彩超等影像学相关指标。Objective To observe the clinical effect of Mongolian medicine Qinggan Jiuwei powder in the treatment of alcoholic liver fibrosis by observing the improvement in imaging indices. Methods A total of 104 patients with alcoholic liver fibrosis who visited Department of Gastroenterology in Horqin District First People＇s Hospital in Tongliao from October 2015 to January 2017 were enrolled and randomly divided into experimental group and control group,with 52 patients in each group. The patients in the experimental group were given Mongolian medicine Qinggan Jiuwei powder,while those in the control group were given reduced glutathione tablets. Liver function parameters,liver-spleen ultrasound findings,and liver stiffness measurement（ LSM） determined by Fibro Scan were observed before and after treatment. The independent samples t-test was used for comparison of normally distributed continuous data between groups,and the paired samples t-test was used for comparison within each group; the Wilcoxon rank sum test was used for comparison of non-normally distributed continuous data between groups. Results Both groups had varying degrees of improvements in clinical symptoms and signs. Both groups had significant changes in alanine aminotransferase,aspartate aminotransferase（ AST）,gamma-glutamyl transpeptidase（ GGT）,and LSM after treatment（ experimental group： Z =-3. 09,-7. 19,and-8. 27,t = 7. 13,P = 0. 002, 〈0. 001, 〈0. 001,and 〈0. 001; control group： Z =-3. 28,-4. 60,and-5. 06,t = 8. 54. P = 0. 001, 〈0. 001,〈 0. 001,and 〈0. 001）. There were significant differences in AST and GGT after treatment between the two groups（ Z =-2. 02 and-2. 15,P = 0. 04 and 0. 03）. Both groups had significant changes in oblique diameter of the right liver lobe,diameter of the portal vein,blood flow rate of the portal vein,spleen thickness,and diameter of the splenic vein after treatment（ experimental group： t = 6. 48,11. 02,2. 20,3. 30 and 5. 30,P〈 0. 001, 〈0. 001,= 0. 030, 〈0. 001,and 〈0. 001;con

关 键 词：蒙药 肝硬化 酒精性 弹性成像技术 

分 类 号：R29[医药卫生—民族医学]