软肝化积丸对瘀血内结型丙型肝炎肝硬化患者纤维化指标和炎症因子的影响  

Effect of Ruangan Huaji Pill(软肝化积丸)on Fibrosis Index and Inflammatory Factor in Patients with Hepatitis C Cirrhosis of Blood Stasis Type

作　　者：刘应东 何伟[1] 汪超 刘丹丹 耿晓源 田水林[1] LIU Yingdong;HE Wei;WANG Chao;LIU Dandan;GENG Xiaoyuan;TIAN Shuilin(Department of Liver Disease,Lu’an Hospital of Traditional Chinese Medicine,Lu’an 237006,China)

机构地区：[1]六安市中医院肝病科,安徽六安237006

出　　处：《山东中医杂志》2023年第12期1274-1281,共8页Shandong Journal of Traditional Chinese Medicine

基　　金：安徽省卫生健康软科学研究项目(编号:AHWJ2020a029)。

摘　　要：目的:观察软肝化积丸对瘀血内结型丙型肝炎肝硬化患者纤维化指标[血清天冬氨酸转氨酶/丙氨酸转氨酶值(AAR)、肝纤维化-4(FIB-4)因子指数]和炎症因子的影响。方法:选择丙型肝炎肝硬化患者101例,按随机数字表法分为观察组50例(脱落1例)、对照组51例(脱落2例)。对照组患者给予常规西医治疗,观察组患者同时给予软肝化积丸治疗,疗程3个月。治疗前后检测两组患者白细胞介素-10(IL-10)、基质细胞衍生因子-1(SDF-1)、趋化因子受体4(CXCR4)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、血小板(PLT)、Ⅲ型前胶原(PⅢNP)、Ⅳ型胶原(CIV)、透明质酸酶(HA)及层粘连蛋白(LN)水平,并计算AAR、FIB-4指数,监测肝脏硬度值、门静脉血流量、门静脉主干内径、门静脉流速、脾脏厚度,比较观察组及对照组中医证候评分及临床疗效,记录两组治疗期间产生的不良反应。结果:治疗后观察组IL-10、SDF-1、CXCR4、FIB-4指数、AAR、AST、ALT、PⅢNP、CIV、HA、LN、肝脏硬度、门静脉主干内径、脾脏厚度、中医证候评分明显低于对照组(P<0.05);观察组门静脉流速、门静脉血流量、总有效率明显高于对照组(P<0.05),两组患者均未发生明显不良反应。结论:软肝化积丸治疗瘀血内结型丙型肝炎肝硬化患者,可改善抑炎因子及促炎因子水平,抑制机体炎症,降低FIB-4、AAR水平,改善肝纤维化病变,降低肝脏硬度水平,改善肝功能、肝血流动力学指标、脾脏厚度,提升临床疗效。Objective:To observe the effects of Ruangan Huaji Pill(软肝化积丸)on fibrosis index[aspartate aminotransferase-alanine aminotransferase ratio(AAR)],liver fibrosis index(FIB-4)and inflammatory factors in patients with ecstatic hepatitis C cirrhosis.Methods:A total of 101 patients with hepatitis C cirrhosis were selected and divided into observation group 50 patients(1 case dropout)and control group 51 cases(2 cases dropouts)according to random number table method.Patients in control group were given conventional western medicine treatment,while patients in observation group were further given Ruangan Huaji Pill treatment.Continuous treatment for 3 months.Levels of interleukin-10(IL-10),stromal cell derived factor 1(SDF-1),chemokine receptor 4(CXCR4),aspartate aminotransferase(AST),alanine aminotransferase(ALT),platelet value(PLT)and typeⅢprecollagen(PⅢNP),typeⅣcollagen(CIV),hyaluronidase(HA)and laminin(LN)were detected before and after treatment,AAR,FIB-4 index,liver stiffness,portal venous flow,portal vein diameter,portal vein velocity,and spleen thickness were measured,and TCM syndrome scores and clinical efficacy of the observation group and control group were compared,and adverse reactions occurred during treatment between the two groups were recorded.Results:After treatment levels of IL-10,SDF-1,CXCR4,AST,ALT,PⅢNP,CIV,HA,LN,scores of FIB-4 index and AAR,liver hardness,portal vein diameter,spleen thickness and TCM syndrome score in observation group were significantly lower than those in control group(P<0.05).The portal vein velocity,portal venous flow and total effectiveness rate in the observation group were significantly higher than those in the control group(P<0.05),and no significant adverse reactions occurred in both groups.Conclusions:Ruangan Huaji Pill can improve the levels of anti-inflammatory factors and pro-inflammatory factors,inhibit body inflammation,reduce scores of FIB-4 index and AAR,improve liver fibrosis,reduce liver stiffness,improve liver function,liver hemodynamic indexes an

关 键 词：软肝化积丸 丙型肝炎肝硬化 炎症因子 肝纤维化指数 肝脏硬度 肝血流动力学 

分 类 号：R289.5[医药卫生—方剂学] R512.63[医药卫生—中药学]