疏肝利胆颗粒治疗原发性胆汁性胆管炎72例的疗效观察  

Observation of the Therapeutic Efficacy of Shugan Lidan Granule on 72 Cases of Primary Biliary Cholangitis

作　　者：宋晓静[1,2] 邵毅 金晓一 杨乐乐 谢延德 拜重阳 SONG Xiaojing;SHAO Yi;JIN Xiaoyi;YANG Lele;XIE Yande;BAI Chongyang(Department of General Surgery,The First Hospital of Lanzhou University,Lanzhou 730000,China;The First Clinical Medical College of Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学第一医院普外科,甘肃兰州730000 [2]兰州大学第一临床医学院,甘肃兰州730000

出　　处：《中医药学报》2024年第11期71-76,共6页Acta Chinese Medicine and Pharmacology

基　　金：甘肃省科技计划项目(22ZD6FA021-4)。

摘　　要：目的:探讨疏肝利胆颗粒治疗原发性胆汁性胆管炎(PBC)胆腑郁热证患者效果。方法:纳入兰州大学第一医院普外科就诊的72例胆腑郁热证PBC患者,根据数字奇偶法分为对照组和治疗组,每组36例。对照组服用熊去氧胆酸胶囊治疗,治疗组服用熊去氧胆酸胶囊+疏肝利胆颗粒治疗。比较两组临床症状、微炎症指标[白细胞介素6(IL-6)、白细胞介素17(IL-17)、肿瘤坏死因子-α(TNF-α)]、肝功能[谷草转氨酶(AST)、总胆红素(TBIL)、谷丙转氨酶(ALT)]、氧化应激指标[丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)]、肝纤维化[血清透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原、Ⅳ型胶原]、免疫球蛋白M(IgM)变化及疗效情况。结果:两组治疗后身热不退、身目发黄、胁肋胀痛、大便秘结、呕吐呃逆、口苦咽干中医证候积分对比,治疗组均低于对照组(P<0.05)。两组治疗后IL-17、IL-6、TNF-α水平均下降(P<0.05),治疗组比对照组更低(P<0.05)。两组TBIL、AST、ALT水平治疗后均下降(P<0.05),治疗组比对照组更低(P<0.05)。两组治疗后MDA水平均降低(P<0.05),治疗组更低(P<0.05),两组治疗后GSH-Px、SOD水平均升高(P<0.05),治疗组更高(P<0.05)。两组治疗后肝纤维化、免疫指标HA、LN、III型前胶原、IV型胶原、IgM水平均下降(P<0.05),治疗组比对照组更低(P<0.05)。治疗后治疗组总有效率显著高于对照组(91.67%vs 72.22%)。结论:疏肝利胆颗粒治疗胆腑郁热证PBC临床疗效显著,能有效促进临床症状及肝功能改善,减轻机体炎症反应及氧化应激反应,改善机体免疫功能、肝纤维化程度,具有较高的临床推广价值。Objective:To explore the efficacy of Shugan Lidan Granule in treating primary biliary cholangitis(PBC)with liver and gallbladder heat syndrome.Methods:Seventy-two PBC patients with liver and gallbladder heat syndrome were included from the Department of General Surgery at The First Hospital of Lanzhou University.They were randomly divided into a control group and a treatment group,with 36 cases in each group.The control group was treated with ursodeoxycholic acid capsule,while the treatment group received ursodeoxycholic acid capsule combined with Shugan Lidan Granule.Clinical symptoms,microinflammatory markers[interleukin-6(IL-6),interleukin-17(IL-17),tumor necrosis factor-alpha(TNF-α)],liver function[aspartate aminotransferase(AST),total bilirubin(TBIL),alanine aminotransferase(ALT)],oxidative stress markers[malondialdehyde(MDA),glutathione peroxidase(GSH-Px),superoxide dismutase(SOD)],liver fibrosis indicators[serum hyaluronic acid(HA),laminin(LN),type III procollagen,type IV collagen],changes in immunoglobulin M(IgM),and overall treatment efficacy were compared between the two groups.Results:After treatment,Traditional Chinese Medicine(TCM)syndrome scores for persistent fever,jaundice,hypochondriac distention and pain,constipation,vomiting,and bitter taste and dry throat were lower in the treatment group compared to the control group(P<0.05).Levels of IL-17,IL-6,and TNF-αdecreased in both groups after treatment(P<0.05),with lower levels in the treatment group(P<0.05).TBIL,AST,and ALT levels also decreased in both groups(P<0.05),with lower levels in the treatment group(P<0.05).MDA levels decreased in both groups(P<0.05),with lower levels in the treatment group(P<0.05),while GSH-Px and SOD levels increased,with higher levels in the treatment group(P<0.05).Liver fibrosis and immunological indicators HA,LN,type III procollagen,type IV collagen,and IgM all decreased after treatment in both groups,with lower levels in the treatment group(P<0.05).The total effective rate in the treatment group was significantly hi

关 键 词：疏肝利胆颗粒 原发性胆汁性胆管炎 临床症状 微炎症 氧化应激 肝功能 

分 类 号：R256.41[医药卫生—中医内科学]