茵陈蒿汤加减联合熊去氧胆酸片治疗湿瘀互结型胆汁淤积性肝病临床观察  

Clinical Observation of Modified Virgate Wormwood Decoction Combined with Ursodeoxycholic Acid in the Treatment of Cholestasis Liver Disease with Combined Syndrome of Dampness and Blood Stasis

作　　者：崔付超 左璐 CUI Fuchao;ZUO Lu(Henan Infectious Disease Hospital,Zhengzhou,Henan,China,450052)

机构地区：[1]河南省传染病医院,河南郑州450052

出　　处：《河南中医》2023年第7期992-996,共5页Henan Traditional Chinese Medicine

基　　金：河南省科技攻关计划项目(20120782)。

摘　　要：目的:观察茵陈蒿汤加减联合熊去氧胆酸片治疗湿瘀互结型胆汁淤积性肝病的临床疗效。方法:选取2020年1月至2022年2月河南省传染病医院收治的80例湿瘀互结型胆汁淤积性肝病患者为研究对象,按照随机数字表法分为观察组和对照组,每组40例。对照组给予熊去氧胆酸片口服治疗,观察组在对照组治疗的基础上给予茵陈蒿汤加减治疗。观察两组患者肝功能指标[谷草转氨酶(aspartate aminotransferase,AST)、谷丙转氨酶(alamine transaminase,ALT)、谷氨酰转移酶(gamma-glutamyl transferase,GGT)、总胆红素(total bilirubin,TBiL)]、肝纤维化指标[透明质酸(hyaluronic acid,HA)、Ⅲ型前胶原(procollagen-Ⅲ,PC-Ⅲ)、Ⅳ型胶原氨基端肽(Ⅳcollagen,Ⅳ-C)、层粘连蛋白(laminin,LN)]、肝门静脉内径、脾静脉内径、肝门静脉平均血流速度、脾静脉平均血流速度变化情况及临床疗效。结果:观察组有效率为100.0%,对照组有效率为85.0%,观察组有效率高于对照组,差异具有显著性(P<0.05);观察组治疗后ALT、AST、GGT、TBiL、HA、PC-Ⅲ、Ⅳ-C、LN水平低于对照组,差异具有显著性(P<0.05);观察组治疗后门静脉内径、脾静脉内径低于对照组,门静脉流速高于对照组,差异有统计学意义(P<0.05),两组脾静脉流速高于治疗前,组间比较,差异无统计学意义(P>0.05)。结论:茵陈蒿汤加减联合熊去氧胆酸片治疗湿瘀互结型胆汁淤积性肝病能提高临床疗效,改善患者肝功能、肝纤维化等血清学、影像学指标。Objective:To observe the clinical efficacy of Modified Virgate Wormwood Decoction combined with Ursodeoxycholic Acid on cholestasis liver disease with combined syndrome of dampness and blood stasis.Methods:A total of 80 patients with cholestasis liver disease with combined syndrome of dampness and blood stasis admitted to Henan Infectious Disease Hospital from January 2020 to February 2022 were selected as the research subjects,and randomly divided into the observation group and the control group,with 40 cases in each group.The control group was given oral treatment with Ursodeoxycholic Acid,while the observation group was given Modified Virgate Wormwood Decoction on the basis of the control group.The change of the liver function indexes[including aspartate transaminase(AST),alanine transaminase(ALT)-gamma glutamyl transfer(GGT),total bilirubin(TBiL),liver fibrosis indexes[including hyal-uronic acid(HA),procollagen II(PC-II),collagen IV amino terminal(IV-C),laminin(LN)J,hepatic portal vein inner diameter,splenic vein inner diameter,hepatic portal vein average blood flow velocity average blood flow velocity of splenic vein and the clinical efficacy were observed.Results:The effective rate of the observation group was 100.0%,while that of the control group was 85.0%.The effective rate of the observation group was higher than that of the control group,and the difference was significant(P<0.05).After treatment,the levels of ALT,AST,GGT,TBiL,HA,PC II,IV-C,and LN in the observation group were significantly lower than those in the control group,and all the differences were significant(P<0.05);The diameter of portal vein and the diameter of splenic vein in the observation group were lower than those in the control group,while the velocity of portal vein was higher than that in the control group,and all the differences were statistically significant(P<0.05);The velocity of splenic vein in the two groups was higher than that before treatment,however,there was no statistically significant difference between the two groups(P

关 键 词：胆汁淤积性肝病 湿瘀互结证 茵陈蒿汤 熊去氧胆酸 《伤寒论》 张仲景 

分 类 号：R256.49[医药卫生—中医内科学]