柴胡疏肝散对肝纤维化患者肝功能、肝纤维化标志物及肝脾超声指标的影响  

Effects of Chaihu Shugan San on hepatic fibrosis in patients

作　　者：王伟杰[1] 席岳 尚立芝[3] 潘晓丽[3] 王琦[3] 田新红[3] 吴珂 王付[3] 

机构地区：[1]河南中医药大学第一附属医院超声科,郑州450003 [2]河南中医药大学针灸推拿学院,郑州450046 [3]河南中医药大学基础医学院,郑州450046

出　　处：《中药药理与临床》2017年第5期166-169,共4页Pharmacology and Clinics of Chinese Materia Medica

基　　金：河南省教育厅科学技术研究重点资助项目(12B360010);郑州市科技领军人才项目(112PLJRC360)

摘　　要：目的:观察柴胡疏肝散治疗肝纤维化的临床疗效。方法:将肝纤维化患者300例随机分成对照组和观察组,150例/组。对照组实施常规保肝治疗,观察组在常规保肝治疗的基础上加用柴胡疏肝散,疗程3个月。治疗前、后患者均测定肝功能、血清肝纤维化及检测肝、脾超声等指标。结果:与对照组比较,观察组的总有效率显著提高(70.6%vs 90.7%)。与对照组比较,观察组治疗后肝功能谷草转氨酶(90.52±21.29 vs 82.39±41.59)、血清谷丙转氨酶(65.15±23.29 vs 61.38±35.11)、γ-谷氨酰转肽酶(62.71±4.25 vs 54.70±4.57)均显著下降,白/球蛋白比值(1.03±0.12 vs 1.33±0.11)显著增加。与对照组比较,治疗后血清肝纤维化标志物透明质酸(213.22±23.51 vs 116.54±13.79)、III型前胶原(81.32±9.71 vs 63.96±14.42)、IV型胶原(85.31±12.32 vs 62.49±13.87)、层粘连蛋白(157.63±24.16 vs 126.09±12.85)含量均显著减少。彩色多普勒超声检查显示,观察组治疗前、后肝门静脉直径(1.36±0.52 vs 1.27±0.51)、脾脏指数(38.76±15.29 vs 25.49±12.63)均显著减小。结论:柴胡疏肝散协同常规保肝治疗,可显著提高对肝纤维化的临床疗效。Objective： To observe the clinical effect of Chaihu Shugan San on hepatic fibrosis in patients. Method： Patients were divided into the control group and the treatment group,who both in two groups were treated by western medicine,while who in the treatment group had additional treatment with Chaihu Shugan San. After 3 months＇ treatment,effects were assessed,and indexes of the liver function,hepatic fibrosis and ultrasonic examination were observed. Results： The effective rate was higher in the treament group with Chaihu Shugan San than that in the control group（70. 6% vs 90. 7%,P〈0. 01）. Levels of AST（90. 52 ± 21. 29 vs 82. 39 ± 41. 59,P〈0. 01）,ALT（65. 15 ± 23. 29 vs 61.38 ± 35. 11,P〈0. 01）,GGT（62. 71 ± 4. 25 vs 54. 70 ± 4. 57,P〈0. 01） in serum were significantly decreased,A/G（1. 03 ± 0. 12 vs 1. 33± 0. 11,P〈0. 05） was increased in the treament group,compared with those in the control group. Levels of hepatic fibrosis indexes such as HA（213. 22 ± 23. 51 vs 116. 54 ± 13. 79,P〈0. 01）,PCIII（81. 32 ± 9. 71 vs 63. 96 ± 14. 42,P〈0. 05）,CIV（85. 31 ± 12. 32 vs 62. 49 ±13. 87,P〈0. 05）,LN（157. 63 ± 24. 16 vs 126. 09 ± 12. 85,P〈0. 01） in serum obviously decreased in the treament group,compared with those in the control group. By color doppler ultrasonography examination,hepatic portal vein diameter（1. 36 ± 0. 52 vs 1. 27 ± 0. 51,P〈0.05）,Spleen index（38. 76 ± 15. 29 vs 25. 49 ± 12. 63,P〈0. 05） were obviously decreased,comparing after the treatment with before the treatment. Conclusion： Chaihu Shugan San combined with hepatic fibrosis can effectively improve therapeutic effect.

关 键 词：柴胡疏肝散 肝功能 肝纤维化 彩色多普勒超声检查 临床疗效 

分 类 号：R259[医药卫生—中西医结合]