滋肾柔肝方配合常规西药治疗自身免疫性肝炎48例临床观察

Clinical observation of combination of prescription of nourishing the kidney and liver and conventional western medicine therapy on autoimmune hepatitis

目的观察滋肾柔肝方配合常规西药治疗自身免疫性肝炎临床疗效。方法将78例自身免疫性肝炎患者随机分为2组,对照组30例予胸腺肽100 mg加入5%葡萄糖注射液100 mL,每日1次静脉滴注,治疗1个月后,改云芝菌胶囊3粒,每日3次口服,治疗2个月;甘草酸二铵200~300 mg加入5%葡萄糖注射液250 mL,每日1次静脉滴注,治疗1个月后,改甘利欣150 mg,每日3次口服,治疗2个月。治疗组48例在对照组治疗基础上加用滋肾柔肝方,每日1剂,水煎取汁300 mL分早晚2次服。治疗3个月后观察2组治疗前后肝功能[丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、γ-谷氨酰转肽酶（γ-GT）、碱性磷酸酶（ALP）、总胆红素（TBiL）]、免疫球蛋白G（IgG）、IgA、IgM及T细胞亚群（CD4、CD8、CD4/CD8）变化。结果 2组治疗后ALT、AST、γ-GT、ALP及TBiL与本组治疗前比较差异均有统计学意义（P〈0.05）,肝功能均有改善;2组治疗后ALT、AST及TBiL比较差异均有统计学意义（P〈0.05）,治疗组改善更明显。2组治疗后IgG均下降（P〈0.05）,治疗组治疗后下降更明显（P〈0.05）。2组治疗后CD4、CD8均有改善（P〈0.05）,CD4以治疗组治疗后改善更显著（P〈0.05）。结论滋肾柔肝方配合常规西药治疗自身免疫性肝炎有较好疗效,对恢复肝功能及调节免疫功能有较好的疗效。

Objective To study the efficacy of combination of prescription of nourishing the kidney and liver and conventional western medicine therapy on autoimmune hepatitis（AIH）.Methods 78 AIH patients were randomized into two groups,48 in treatment group,others in control.In control group,the patients are treated with Thymus peptides injection 100 mg in 5% GS 100 mL intravenous drip once a day for 1 month.Then patients received Yunzhijun capsule,3 pills thrice a day for 2 months.Then therapy was changed to Diammonium glycyrrhizinate 200~300 mg in 5% GS 100 mL intravenous drip once a day for 1 month.Finally patients received Ganlixin 150 mg,thrice a day for 2 months.The treatment group is treated not only by conventional therapy but also prescription of nourishing the kidney and liver 150 mL,two times a day for three months.After three months of treatment,the clinical symptoms,liver function,immunoglobulin,T cells,and antibody were measured.Results There were significant differences between before and after treatment on ALT,AST and TBiL in two groups（P0.05）,the treatment group improved more significantly.After treatment IgG decreased in two groups（P0.05）,treatment group decreased more significantly（P0.05）.After treatment CD4,CD8 were improved（P0.05）,CD4 in treatment group improved more significantly after treatment（P0.05）.Conclusion The combination of prescription of nourishing the kidney and liver and conventional western medicine treatment has a good effect on liver function and regulation of immune function in patients with AIH.