肝脏FibroTouch技术联合血清无创肝纤维化模型观察肝豆扶木汤对肝豆状核变性肝纤维化的临床疗效  

Study on the clinical effect of Gandou Fumu Decoction on hepatic fibrosis in Wilson's disease by liver FibroTouch technique combined with serum noninvasive liver tibrosis model

作　　者：张艳云 汪美霞[1] 杨文明[1,3] 陶庄 王飞 李祥 张静[1] ZHANG Yan-yun;WANG Mei-xia;YANG Wen-ming;TAO Zhuang;WANG Fei;LI Xiang;ZHANG Jing(Department of Encephalopathy,The First Affliated Hospital of Anhui University of CM,Hefei 230031,China;Graduate School,Anhui University of Chinese Medicine,Hefei 230038,China;Key Laboratory of Xinan Medicine,Ministry of Education,Hefei 230031,China)

机构地区：[1]安徽中医药大学第一附属医院脑病科,合肥230031 [2]安徽中医药大学研究生院,合肥230038 [3]新安医学教育部重点实验室,合肥230031

出　　处：《中华中医药杂志》2023年第4期1868-1873,共6页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：青年岐黄学者培养项目(No.国中医药人教函[2022]256号);安徽省青年领军后备人才项目(No.中发展[2022]4号);国家自然科学基金项目(No.81973825,No.82104783);国家中医药管理局中医药循证能力建设项目(No.2019XZZX-NB001)。

摘　　要：目的:研究FibroTouch(FT)技术联合血清无创肝纤维化模型(NIT)对肝豆状核变性(WD)肝纤维化的诊断价值及肝豆扶木汤对WD肝纤维化的临床疗效。方法:系统回顾性收集WD肝纤维化患者68例随机分为治疗组和对照组,每组34例。对照组予以常规西药治疗,治疗组在对照组基础上加用中药汤剂肝豆扶木汤进行治疗。统计肝硬度值(LSM)、肝脏血清学指标[透明质酸(HA)、Ⅳ型胶原(C-Ⅳ)、层黏连蛋白(LN)、Ⅲ型前胶原N端肽(PⅢNP)、谷丙转氨酶(ALT)、门冬氨酸氨基转移酶(AST)、γ-谷氨酰转移酶(γ-GGT)]、血小板(PLT)及NIT模型评分,分析LSM及NIT模型的曲线下面积,计算约登指数(YI)。结果:两组治疗后肝脏各项指标均较治疗前显著改善(P<0.01,P<0.05);治疗组治疗后LSM值、NIT模型指标、ALT、AST、PLT、HA、LN指标改善较对照组更显著(P<0.01,P<0.05);联合诊断的诊断价值高于单项诊断。结论:FT技术与血清NIT联合提高了WD肝纤维化的诊断准确性;肝豆扶木汤具有逆转WD肝纤维化进程作用。Objective:To study the diagnostic value of liver FibroTouch(FT)technique combined with serum noninvasive liver fibrosis model(NIT)for hepatic fibrosis in patients with hepatolenticular degeneration and the clinical effect of Gandou Fumu Decoction on hepatic fibrosis in Wilson's disease.Methods:A total of 68 patients with WD liver fibrosis were systematically retrospectively collected and randomly divided into treatment group and control group,34 patients in each group.The control group was treated with western medicine,and the treatment group was treated with traditional Chinese medicine decoction Gandou Fumu Decoction on the basic treatment of the control group.Liver hardness value(LSM),liver serological indicators(HA,C-IV,LN,P IINP,ALT,AST,-GGT),PLT and NIT models were counted,the area under the curve of LSM and NIT models were analyzed,and the Youden index(YI)was calculated.Results:After treatment,the liver indexes of the two groups were significantly improved than that before treatment(P<0.01,P<0.05).In the treatment group,LSM value,NIT score,ALT,AST,PLT,HA,LN indicators improved more significantly than that in the control group(P<0.01,P<0.05).The diagnostic value of combined diagnosis was superior to the single diagnosis.Conclusion:FT technique combined with serum NIT could improve the diagnostic accuracy of WD hepatic fibrosis;Gandou Fumu Decoction can reverse the process of WD liver fibrosis.

关 键 词：FibroTouch技术 无创肝纤维化模型 肝纤维化 肝豆状核变性 ROC曲线 诊断 疗效 

分 类 号：R259[医药卫生—中西医结合]