苦黄注射液联合复方蛋氨酸胆碱治疗酒精性脂肪肝的疗效及对肝纤维化的影响研究  

Clinical efficacy of Kuhuang injection combined with compound methionine and choline bitartrate tablets in the treatment of alcoholic fatty liver and its effect on liver fibrosis

作　　者：林笑晗 贲腾 田尧 马林 LIN Xiaohan;BEN Teng;TIAN Yao;MA Lin(Department of Gastroenterology,Hai'an People's Hospital,Hai'an 226600,Jiangsu,China;Department of Imaging,Hai'an People's Hospital,Haian 226600,Jiangsu,China)

机构地区：[1]海安市人民医院消化内科,江苏海安226600 [2]海安市人民医院影像科,江苏海安226600

出　　处：《转化医学杂志》2022年第4期233-236,217,共5页Translational Medicine Journal

摘　　要：目的探究复方蛋氨酸胆碱结合苦黄注射液在酒精性脂肪肝治疗中的疗效及对肝纤维化的影响。方法按照随机数字表法将2019年1月至2021年12月海安市人民医院收治并确诊的104例酒精性脂肪肝患者分为对照组和观察组,各52例。对照组给予复方蛋氨酸胆碱治疗,观察组苦黄注射液联合复方蛋氨酸胆碱治疗。两组患者均连续治疗1个月。采用全自动生化分析仪检测两组患者治疗前后血清丙氨酸转移酶(alanine trans-ferase,ALT)、天冬氨酸转氨酶(aspartate aminotransferase,AST)、总胆固醇(total cholesterol,TC)、三酰甘油(triacylg-lycerol,TG)、总胆红素(total bilirubin,TBil)水平;采用放射免疫法检测两组患者治疗前后血清层粘连蛋白(laminin,LN)、透明质酸(hyaluronic acid,HA)、Ⅲ型前胶原N端肽(type III procollagen N-terminal peptide,PCⅢ)及Ⅳ型胶原(type IV collagen,Ⅳ-C)水平。比较两组患者的临床症状改善情况、临床疗效、肝功能指标及肝纤维化指标。结果观察组治疗后的腹胀、肝区不适、黄疸、痞满等症状消失时间分别为(3.9±0.1)d、(9.8±0.2)d、(11.5±0.7)d、(3.8±0.2)d,均短于对照组分别为(7.5±0.3)d、(14.3±0.4)d、(15.6±0.8)d、(7.4±0.3)d(均P<0.05)。观察组临床总有效率高于对照组(94.2%vs 78.9%)(χ^(2)=5.283,P=0.022)。观察组ALT、AST、TC、TG、TBil水平分别为(31.5±5.3)IU/L、(36.4±3.4)IU/L、(4.1±0.2)mmol/L、(1.4±0.3)mmol/L、(12.6±3.1)μmol/L,低于对照组[分别为(57.4±5.6)IU/L、(54.7±3.5)IU/L、(6.4±0.4)mmol/L、(2.6±0.5)mmol/L、(21.2±5.3)μmol/L(]均P<0.05)。观察组治疗后LN、HA、PCⅢ、Ⅳ-C水平分别为(51.6±9.4)μg/L、(32.5±7.4)μg/L、(7.5±1.8)ng/mL、(32.3±4.2)μg/L,均低于对照组[分别为(80.5±10.3)μg/L、(58.7±12.2)μg/L、(16.5±3.6)ng/mL、(71.2±8.6)μg/L(]均P<0.05)。对照组和观察组不良反应发生率分别为7.68%、3.84%,两组比较无明显差异(χ^(2)=0.707,P=0.400)。结论复方蛋氨酸胆�Objective To investigate the clinical efficacy of Kuhuang injection combined with compound methio-nine and choline bitartrate tablets in the treatment of alcoholic fatty liver,and to explore its effect on liver fibrosis.Methods One hundred and four patients with alcoholic fatty liver in Hai'an People's Hospital from January 2019 to December 2021 were classified into two groups by random number table methods with 52 cases in each group.Control group received compound methionine and choline bitartrate tablets,and observation group was given Kuhuang injection combined with compound methionine and choline bitartrate tablets.Treatment in both groups lasted for 1 month.The automatic biochemical analyzer was applied to detect the serum alanine transferase(ALT),aspartate aminotransferase(AST),total cholesterol(TC),triacylglycerol(TG)and total bilirubin(TBil),and radioimmunoassay was adopted to de-tect levels of laminin(LN),hyaluronic acid(HA),type-III procollagen(PC-III)and type-IV collagen(IV-C).Then com-parison was conducted on the clinical improvement,clinical efficacy,liver function and liver fibrosis parameters be-tween the two groups.Results The disappearance time of clinical symptoms including abdominal distension,discom-fort in the hepatic region,jaundice,and fullness were(3.9±0.1)d,(9.8±0.2)d,(11.5±0.7)d and(3.8±0.2)d in the observa-tion group,which were shorter than these in the control group(7.5±0.3d,14.3±0.4d,15.6±0.8d and 7.4±0.3d,P<0.05).Observation group achieved higher clinical efficacy rate than the control group(94.2%vs 78.9%,χ^(2)=5.283,P=0.022).Serum levels of ALT,AST,TC,TG and TBil were(31.5±5.3)IU/L,(36.4±3.4)IU/L,(4.1±0.2)mmol/L,(1.4±0.3)mmol/L and(12.6±3.1)μmol/L in observation group,which were lower than these in the control group(57.4±5.6IU/L,54.7±3.5IU/L,6.4±0.4mmol/L,2.6±0.5mmol/L and21.2±5.3μmol/L,P<0.05).Serum levels of LN,HA,PCⅢandⅣ-C were also lower than that in the control group(P<0.05).The adverse reaction rate was 7.68%in control group and 3.84%in observation gr

关 键 词：苦黄注射液 复方蛋氨酸胆碱 酒精性脂肪肝 疗效 肝纤维化 

分 类 号：R575.5[医药卫生—消化系统]