自拟茵陈三草汤联合熊去氧胆酸胶囊治疗Ⅰ型自身免疫性肝炎27例临床研究  

Clinical study on Yinchen Sancao Decoction(茵陈三草汤)Treating 27 Cases of Type I Autoimmune Hepatitis

作　　者：王大光 邓琳琳 薛红杰 陈福来(指导) WANG Daguang;DENG Linlin;XUE Hongjie;CHEN Fulai(Yancheng Hospital of Traditional Chinese Medicine,Yancheng 210029,Jiangsu,China)

机构地区：[1]盐城市中医院肝胆内科,江苏盐城210029

出　　处：《实用中医内科杂志》2021年第8期21-24,共4页Journal of Practical Traditional Chinese Internal Medicine

基　　金：财政部、国家中医药局医疗卫生与计划生育支出—中医(名族医)药专项(2100601);江苏省财政厅中医药管理局省中医药事业发展省级补助资金(1100249)。

摘　　要：目的研究茵陈三草汤加减联合熊去氧胆酸胶囊治疗I型自身免疫性肝炎的临床疗效。方法选取确诊为I型自身免疫性肝炎患者72例,分为对照组20例、激素组25例、中药组27例。对照组采取熊去氧胆酸胶囊治疗;激素组采用甲泼尼龙联合熊去氧胆酸胶囊治疗;中药组为中西医结合组,采用茵陈三草汤辨证加减联合熊去氧胆酸胶囊治疗。观察治疗前后三组谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷氨酰转移酶(GGT)、球蛋白(GLB)、γ球蛋白、免疫球蛋白IgA和IgG以及肝纤四项中透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PCIII)、IV型胶原(IV-C)变化情况。结果治疗后激素组、中药组对于ALT、AST、GLB以及γ球蛋白、IgG改善优于对照组(P<0.05);中药组对于HA、LN、IV-C改善优于对照组(P<0.05),且对于LN、IV-C改善优于激素组(P<0.05)。有效率激素组、中药组均优于对照组(P<0.05),中药组、激素组之间差异无统计学意义(P>0.05);激素组出现3例睡眠障碍,对照组以及中药组未见相关不良反应。结论茵陈三草汤辨证加减联合熊去氧胆酸治疗I型自身免疫性肝炎,可提高临床治疗效果,改善肝功能及肝纤维化指标,且安全性性好,值得推广。Objective To study the clinical effect of Yinchen Sancao Decoction(茵陈三草汤) combined with UDCA in the treatment of type I autoimmune hepatitis.Methods Seventy-two patients with type I autoimmune hepatitis were divided into control group(20 cases), hormone group(25 cases) and traditional Chinese medicine group(27 cases). The control group was treated with UDCA. The hormone group was treated with methylprednisolone combined with UDCA. The traditional Chinese medicine group was treated with the combination of Yinchen Sancao Decoction and UDCA. The changes of ALT, AST, GGT, GLB, γ-globulin, IgA and IgG, HA, LN, PCIII and IV-C were observed before and after treatment. Results After treatment, the improvements of ALT, AST, GLB, γ-globulin and IgG in the hormone group and traditional Chinese medicine group were better than those in the control group(P<0.05). The improvements of HA, LN and IV-C in the traditional Chinese medicine group were better than those in the control group(P<0.05), and the improvements of LN and IV-C in traditional Chinese medicine group were better than those in the hormone group(P<0.05). The effective rates of the hormone group and Chinese medicine group were better than that of the control group(P<0.05). There was no difference between the traditional Chinese medicine group and the hormone group(P>0.05).There were 3 sleep disorders in the hormone group, and there was no related adverse reactions in the control group and traditional Chinese medicine group. Conclusion Yinchen Sancao Decoction combined with UDCA in the treatment of type I autoimmune hepatitis can improve the clinical effect, the liver function and liver fibrosis index, and has good safety, which is worthy of popularizing.

关 键 词：茵陈三草汤 I型自身免疫性肝炎 中西医结合 

分 类 号：R259[医药卫生—中西医结合]