疏肝活血汤治疗酒精性肝病的临床疗效及对肝功能和肝纤维化指标的影响  

Clinical efficacy of Shugan Huoxue Decoction for alcoholic liver disease and how it impacts on liver function and liver fibrosis indexes

作　　者：赵红心[1] 李术先 张志勇 姚志山[3] ZHAO Hongxin;LI Shuxian;ZHANG Zhiyong;YAO Zhishan(Department of Liver,Gallbladder,Spleen and Stomach,Fengrun Hospital of Traditional Chinese Medicine,Tangshan,Hebei 064000;不详)

机构地区：[1]河北省唐山市丰润区中医医院肝胆脾胃科,河北唐山064000 [2]河北省唐山市丰润区中医医院重症监护室,河北唐山064000 [3]河北省唐山市丰润区第二人民医院内四科,河北唐山064000

出　　处：《河北中医》2021年第11期1813-1817,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局2020年度中医药类科研计划课题(编号:2020406)。

摘　　要：目的观察疏肝活血汤治疗酒精性肝病(ALD)的临床疗效及对肝功能和肝纤维化指标的影响。方法将98例ALD患者按照随机数字表法分为2组,对照组49例予水飞蓟宾胶囊治疗,治疗组49例在对照组治疗基础上加疏肝活血汤治疗,2组均4周为1个疗程,共治疗3个疗程后统计比较2组临床疗效。比较2组治疗前后肝功能指标总胆红素(TBiL)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、γ-谷氨酰氨基转移酶(GGT)水平,以及肝纤维化相关指标Ⅳ型胶原(Ⅳ-C)、Ⅲ型前胶原(PCⅢ)、层黏连蛋白(LN)、透明质酸(HA)水平和肝脏硬度(LSM)值。观察2组用药期间有无药物相关不良反应及过敏反应发生。结果对照组剔除4例,共45例完成治疗;治疗组剔除3例,共46例完成治疗。治疗组总有效率89.13%(41/46),对照组总有效率71.11%(32/45),2组总有效率比较差异有统计学意义(P<0.05),治疗组临床疗效优于对照组。治疗后2组肝功能指标血清TBiL、GGT、AST和ALT水平,肝纤维化指标血清Ⅳ-C、PCⅢ、LN和HA水平以及LSM值均较本组治疗前下降,且治疗组均低于对照组,比较差异均有统计学意义(P<0.05)。治疗组不良反应总发生率17.39%(8/46),对照组为11.11%(5/45),2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论加用疏肝活血汤治疗ALD不仅能提高临床疗效,改善患者肝功能,还可以减轻肝纤维化程度,从而延缓疾病进程,且无不良反应增加。Objective To observe the clinical efficacy of Shugan Huoxue Decoction for alcoholic liver disease(ALD)and how it impacts on liver function and liver fibrosis indexes.Methods Totally 98 patients with ALD were grouped into equal group according to the random number table,in addition to silibinin capsule,patients in treatment group additionally received Shugan Huoxue Decoction.The treatment continued for 3 course(1 course for 4 weeks),the aim was to compare liver function indexes[total bilirubin(TBiL),alanine aminotransferase(ALT),aspartate aminotransferase(AST),gamma-glutamyl transferase(GGT)],liver fibrosis indexes[typeⅣcollagen(Ⅳ-C),procollagen typeⅢ(PCⅢ),laminin(LN),hyaluronic acid(HA),liver stiffness measurement(LSM)];the curative effect,drug-related adverse reaction and anaphylaxis were counted.Results There were 45(4 cases excluded)and 46 cases(3 cases excluded)in control group and treatment group completed the treatment,respectively.The total effective rates were 89.13%(41/46)in treatment group,better than those of 71.11%(32/45)in control group,the difference being significant(P<0.05).After treatment,liver function indexes and liver fibrosis indexes in groups were decreased,which decreased in treatment group compared with cortrol group,and with statistically significant difference(P<0.05).The total incidence of adverse reactions in treatment group and control group was 17.39%(8/46)and 11.11%(5/45),respectively,the difference of two groups being not significant(P>0.05).Conclusion For patients with ALD,Shugan Huoxue Decoction is capable of improving clinical efficacy,liver function,reducing degree of liver fibrosis,thereby it can delay disease progression and without adverse reactions.

关 键 词：肝病 酒精性 肝病辨证 疏肝 活血 肝功能 临床疗效 

分 类 号：R575.105.31[医药卫生—消化系统]