血浆置换联合穴位注射对重型肝炎患者肝纤维化指标的影响

Effect of plasma exchange with acupuncture point injection on liver fibrosis indexes in patients with severe hepatitis

目的:探讨血浆置换联合穴位注射治疗对重型肝炎患者肝纤维化指标的影响。方法:将收治的60例重型肝炎患者随机分为2组:A组29例,在常规内科治疗基础上配合血浆置换术;B组31例,在A组治疗基础上同时给予黄芪注射液足三里穴位注射治疗;观察两组患者治疗后血清透明质酸(HA)、层粘连蛋白(LN)、Ⅳ型胶原(Ⅳ-C)、Ⅲ型前胶原(PCⅢ)4项肝纤维化指标水平的变化情况,并与30例健康体检者(C组)比较。结果:治疗前A、B两组肝纤维化指标水平差异无统计学意义(P>0.05),但都高于C组(P<0.001);治疗后两组各项指标水平均下降,其中B组各项指标下降尤为显著,两组比较差异有统计学意义(P<0.05或P<0.001);B组治疗后与C组比较,Ⅳ-C、PCⅢ两项指标差异无显著性(P>0.05)。结论:血浆置换联合黄芪足三里穴位注射治疗能有效改善重型肝炎患者肝纤维化指标,从而改善患者预后。

Objective To investigate the influence of plasma exchange with acupuncture point injection therapy on liver fibrosis indexes in patients with severe hepatitis. Methods Sixty patients with severe hepatitis were randomly divided into group A with 29 cases receiving plasma replacement and group B of 31 cases receiving astragalus injection at Zusanli point in addition to plasma replacement. Changes of liver fibrosis indexes including serum hyaluronic acid （HA）, laminin （LN）, collagen IV （Ⅳ- C）, type m pre-collagen （PC Ⅲ ） were observed, which were compared with those from group C with 30 healthy subjects. Results Before treatment, there was no statistical significance in comparison of liver fibrosis index in group A and B （P 〉 0.05）, but all the indexes were higher than those in group C （P 〈 0.001 ）. After treatment, the level of each index in group A and B was down with a more significant change in group B and the comparison of both groups indicated statistieal significance （P 〈 0.05 or P 〈 0.001 ） ; Compared with those in group C, changes of Ⅳ- C, PC m in group B showed no significant difference （P 〉 0.05）. Conclusion Plasma exchange with astragalus injection at Zusanli point can effectively improve liver fibrosis indexes in patients with severe hepatitis and then improve the prognosis of patients.