中药联合熊脱氧胆酸治疗老年女性原发性胆汁性肝硬化失代偿期的临床疗效  被引量:1

Clinical efficacy of traditional Chinese medicine combined with ursodeoxycholic acid in treating decompensated primary biliary cirrhosis in elderly women

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作  者:高司成 柴海生 杨海琳 王一凤 喻晓[3] 祝峻峰 GAO Sicheng;CHAI Haisheng;YANG Hailin;WANG Yifeng;YU Xiao;ZHU Junfeng(Department of Liver Disease,Yueyang Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Department of Liver Disease,Shanghai Municipal Traditional Chinese Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China;Department of Liver Disease,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)

机构地区:[1]上海中医药大学附属岳阳中西医结合医院肝病科,上海200437 [2]上海中医药大学附属市中医医院肝病科,上海200071 [3]上海中医药大学附属龙华医院肝病科,上海200032

出  处:《上海中医药杂志》2024年第2期79-83,共5页Shanghai Journal of Traditional Chinese Medicine

基  金:国家自然科学基金项目(82305334,82074386);上海市卫健委肝硬化腹水(水臌病)上海市中医专病联盟项目(2021-2023);上海市科委“科技创新行动计划”生物医药科技支撑专项(23S21900100)。

摘  要:目的 观察中药联合熊脱氧胆酸(UDCA)治疗老年女性原发性胆汁性肝硬化(PBC)失代偿期患者的临床疗效。方法将收集的老年女性PBC失代偿期患者72例随机分为治疗组和对照组,每组36例。治疗组予失笑散合二至丸颗粒联合UDCA治疗,对照组予失笑散合二至丸颗粒模拟剂联合UDCA治疗。疗程均为6个月,观察中医证候疗效及不良反应发生率,比较相关生化指标、肝硬度值(LSM)、蔡尔德-特科特-皮尤改良评分(CTP)的变化情况。结果 (1)最终完成试验者64例,治疗组32例、对照组32例。(2)治疗前与治疗6个月组内比较,两组总胆红素(TBil)、碱性磷酸酶(ALP)、丙氨酸转氨酶(ALT)、总胆汁酸(TBA)、白球比(A/G)水平差异有统计学意义(P<0.05);组间治疗6个月比较,上述各指标差异无统计学意义(P>0.05)。治疗前与治疗6个月组内比较,两组雌二醇(E2)水平差异有统计学意义(P<0.05);组间治疗6个月比较,E2水平差异有统计学意义(P<0.05)。(3)治疗前与治疗6个月组内比较,两组LSM水平差异有统计学意义(P<0.05);组间治疗6个月比较,LSM水平差异有统计学意义(P<0.05)。(4)治疗前与治疗6个月、随访1年组内比较,两组CTP的A级构成比均增加,差异有统计学意义(P<0.05);组间治疗6个月、随访1年比较,治疗组CTP的A级构成比均明显高于对照组(P<0.05)。(5)治疗组、对照组总有效率分别为93.75%、68.75%;组间中医证候疗效比较,治疗组明显优于对照组(P<0.05)。(6)两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 中药(失笑散合二至丸)联合UDCA治疗老年女性PBC,能改善患者的肝功能储备及临床症状,保肝利胆且不良反应较少。Objective To observe the clinical efficacy of traditional Chinese medicine(TCM)combined with ursodeoxycholic acid(UDCA)in treating elderly female patients with decompensated primary biliary cirrhosis(PBC).Methods Seventy-two elderly female patients with decompensated PBC were randomly divided into a treatment group(n=36)and a control group(n=36).The treatment group received a combination of specific TCM formulas(Shixiao San and Erzhi Wan granules)and UDCA,while the control group received placebo equivalents of the TCM formulas combined with UDCA.Both groups underwent a six-month treatment period.The efficacy of TCM symptoms and the occurrence of adverse reactions were noted,and changes in relevant biochemical indicators,liver stiffness measurements(LSM),and Child-Turcotte-Pugh(CTP)scores were compared.Results①A total of 64 patients completed the trial,with 32 in each group.②Sigificant differences were observed in the levels of TBil,ALP,ALT,TBA and A/G within each group when comparing pre-treatment values with those after six months of treatment(P<0.05).However,there were no significant differences in these indicators between the groups after six months of treatment(P>0.05).Significant differences in E2 levels were observed both within and between groups before and after 6-month treatment(P<0.05).③Significant differences in LSM levels were observed within both groups before and after 6-month treatment(P<0.05).Upon comparison after six months of treatment between the groups,the difference in LSM levels was statistically significant(P<0.05).④The proportion of patients in CTP class A increased significantly in both groups after six months of treatment and after one year of follow-up(P<0.05),with the treatment group always having a higher proportion than the control group(P<0.05).⑤The overall effectiveness rates were 93.75%in the treatment group and 68.75%in the control group,with the treatment group showing significantly better TCM symptom efficacy(P<0.05).⑥The incidence of adverse reactions did not diffe

关 键 词:肝硬化 自身免疫性肝病 中药 熊脱氧胆酸 老年女性 肝功能 

分 类 号:R575.2[医药卫生—消化系统]

 

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