和肝汤治疗肝郁脾虚型肝纤维化的临床分析  

Clinical Analysis of Hegan Tang in the Treatment of Liver Fibrosis with Type of Pi-deficiency and Liver-Qi Stagnation

作　　者：李雅洁[1] 安丽[1] 黄粤[1] 宋亚芳[2] Li Yajie;An Li;Huang Yue;Song Yafang(Department of Traditional Chinese Medicine,Beijing Chaoyang Hospital Affiliated to Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院中医科,北京市100020 [2]首都医科大学燕京医学院,北京市101300

出　　处：《中国病案》2018年第9期107-109,共3页Chinese Medical Record

基　　金：首都中医药研究专项课题(16ZY14)

摘　　要：目的探讨和肝汤治疗肝纤维化(肝郁脾虚证)的疗效及对肝脏纤维化程度、肝纤维化四项、CTGF、MMP-2及TIMP-1水平的影响。方法选取2015年10月-2017年10月住院的肝郁脾虚型肝纤维化患者68例,随机分为观察组和对照组各34例,对照组口服多烯磷脂酰胆碱胶囊228mg,每日3次保肝治疗;观察组在对照组治疗的基础上服用和肝汤,每天1剂水煎,早晚内服。两组疗程均为3个月。比较治疗前后患者症状体征积分、肝脏硬度值,评价治疗后临床疗效,对比治疗前后检测两组患者肝纤维化四项、血清CTGF、MMP-2及TIMP-1水平。结果观察组治疗后症状体征积分、肝脏硬度值均显著低于对照组;治疗后观察组血清HA、LN、PCⅢ、IV-C、CTGF、MMP-2及TIMP-1均显著低于对照组;观察组临床总有效率为94.1%,明显高于对照组的70.5%。结论和肝汤治疗肝纤维化(肝郁脾虚证),能明显改善患者症状体征积分,提高临床疗效,其机制可能与下调血清CTGF、MMP-2及TIMP-1水平有关。Objective To investigate the clinical efficacy of Hegan Tang in treatment of liver fibrosis（pi-deficiency and liver-qi stagnation） and its effects on levels of liver fibrosis、CTGF、MMP-2 and TIMP-1 in serum. Methods Sixty-eight patients with liver fibrosis were elected and randomly divided into observation group 34 cases and control group 34 cases according to their hospitalization sequence.All patients orally took polyene phosphatidylcholine capsules. Patients in observation group were given with Hegan Tang 1 dose per day,bid,patients in both groups were treated for 3 months. The levels of CTGF、MMP-2、TIMP-1 and Transient elasticity values were detected in both groups. Results The total effective rate was 94.1% in observation group,higher than 70.5% in control group.After treatment,the level of CTGF、MMP-2 and TIMP-1 in serum of observation group was significantly lower than those of control group,with statistically significant differences.Conclusions Hegan Tang had definite efficacy in treatment of liver fibrosis（Spleen deficiency and Liver-Qi Stagnation）,and the therapeutic effect may be related with down-regulating the levels of CTGF、MMP-2 and TIMP-1 levels in serum.

关 键 词：和肝汤 肝郁脾虚 肝纤维化 

分 类 号：R259[医药卫生—中西医结合]