软肝升白汤对乙型肝炎肝硬化患者瘦素、胰岛素生长因子-1、生长激素、血清白蛋白水平的影响

The influence of Ruangan Shengbai decoction to LEP,IGF-1,GH and Alb in patients with hepatitis cirrhosis

目的:了解软肝升白汤对乙型肝炎肝硬化患者血清瘦素(LEP)、胰岛素生长因子-1(IGF-1)、生长激素(GH)、白蛋白(Alb)水平的影响,探讨其作用机制。方法:将36例乙型肝炎肝硬化患者随机分为两组,治疗组22例,对照组14例。36例均采用基础护肝疗法,治疗组患者在此基础上加用软肝升白汤,1剂/d,疗程均为3个月。治疗前和治疗结束时检测患者血清LEP、IGF-1、GH、Alb水平,并进行统计学分析。结果:治疗组患者Alb、IGF-1水平升高,而GH、LEP水平下降,与对照组比较,差异有显著性意义(P<0·05)。治疗组患者脾厚、门静脉及脾静脉内径明显缩小,肝纤维化4项指标明显改善,与对照组比较,差异也有显著性意义(均P<0·05)。结论:软肝升白汤能提高乙型肝炎肝硬化患者Alb、IGF-1水平,下调GH、LEP水平,其机制是否与其能改善胰岛素抵抗、调整IGF-1与GH之间的负反馈关系、提高Alb水平有关,尚需进一步研究。

Objective： To study the influence of Ruangan Shengbai decoction to LEP, IGF-1, GH and Alb in hepatitis cirrhosis and its mechanism. Methods： Thirty-six patients with cirrhosis were divided randomly into two groups which included 22 cases of treatment group and 14 cases of control group. All patients were treated by basis therapy but treatment group had been added a dose Ruangan Shengbai decoction everyday for three months. The levels of serum LEP, IGF-1, GH, Alb and thickness of splenic hilus, size of portal vein and spleen vein of ultrasonography in all patients with cirrhosis were measured before and after treatment. The statistics analysis was calculated. Results ： The levels of serum Alb and IGF-1 increased but GH and LEP fallen in treatment group ; Two groups had significantly difference （ P 〈 0. 05 ） . Conclusion ： Ruangan Shengbai decoction will raise levels of serum Alb and IGF-1 but reduse GH and LEP in patients with cirrhosis. Maybe it can ameliorate IR resistance and adjust negative feedback between IGF-1 and GH.