清热利湿法治疗酒精性肝炎疗效观察

Observation on the Method of Clearing Heat and Removing Dampness in Treating Alcoholic Hepatitis

目的 :探讨清热利湿法治疗酒精性肝炎的临床疗效及机制。方法 :4 5例酒精性肝炎患者随机分为两组 ,治疗组 30例采用清热利湿法治疗 ,对照组 15例采用常规西药治疗 ,观察两组临床疗效与外周血白细胞介素 - 8(IL-8)、超氧化物歧化酶 (SOD)、丙二醛 (MDA)水平及肝功能变化的关系。结果 :经治疗后治疗组患者外周血 IL- 8、MDA水平均明显下降 (P <0 .0 5 ,<0 .0 1) ,SOD活性明显上升 (P <0 .0 5 ) ,对照组患者外周血 MDA水平均明显下降 (P <0 .0 5 ) ;两组肝功能得到不同程度恢复 ;症状不同程度得到改善 ;两组总有效率比较差异无显著性意义(P >0 .0 5 ) ,但两组显效率比较差异有显著性意义 (P <0 .0 5 )。结论 :清热利湿法对酒精性肝炎具有较好疗效 ,其机制可能与下调炎症细胞因子 IL- 8水平 ,减轻肝脏脂质过氧化反应等有关。

Objective:To observe the clinical effect of the method of clearing heat and removing dampness(MCHRD) on alcoholic hepatitis.Methods:45 patients with alcoholic hepatitis were randomly divided into two groups: treatment group of 30 cases treated with MCHRD, control group of 15 treated with usual western medicine.The clinical therapeutic effect, the level of IL 8,MDA,SOD in plasma and liver function were tested before and after treatment.Results: After one month's treatment,the level of IL 8 and MDA in treatment group were significantly decreased(P< 0.05 ,P< 0.01 ),that of SOD was significantly increased(P< 0.05 ).The level of MDA in control group was significantly decreased (P< 0.05) ). Liver function in two groups were recovered and clinical symptoms were improved in different degree. There was no significant difference between the total effective rates of the two groups(P< 0.05 ),but there was significant difference between the apparent effective rates (P< 0.05 ).Conclusion:MCHRD has better therapeutic effect on alcoholic hepatitis.The mechanism might be related to down regulating the level of inflammation cytokine IL 8 and relieving lipid peroxidation of liver.