中西医结合治疗酒精性肝炎52例临床观察

Clinical observation of combined therapy of traditional Chinese and western medicine on alcoholic hepatitis

目的观察酒肝消方联合西药治疗酒精性肝炎临床疗效。方法将100例酒精性肝炎患者随机分2组。对照组48例予西医常规治疗,治疗组52例在对照组治疗基础上加用酒肝消方。2组均治疗3个月后观察临床疗效,并观察2组治疗前后血清学指标[天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、γ-谷氨酰转移酶(γ-GT)及凝血酶原时间(PT)]、肝纤维化指标[透明质酸(HA)、Ⅲ型前胶原(PCⅢ)及层黏连蛋白(LN)]及影像学(B超、CT)变化。结果治疗组总有效率80.77%,对照组总有效率58.33%,2组比较差异有统计学意义(P<0.05),治疗组疗效优于对照组。2组治疗后ALT、AST、γ-GT及PT均降低(P<0.05),且治疗组降低优于对照组(P<0.05)。B超比较,治疗组治疗后远场回声衰减、管道结构显示不清、肝肿大、血流信号减少与本组治疗前比较差异有统计学意义(P<0.05);对照组治疗后管道结构显示不清、肝肿大2项与治疗前比较差异有统计学意义(P<0.05);但远场回声衰减治疗组优于对照组(P<0.05)。CT肝与脾比值比较,治疗组治疗后轻度、中度与本组治疗前比较差异有统计学意义(P<0.05);对照组治疗前后比较差异无统计学意义(P>0.05)。2组治疗后HA、PCⅢ及LN均降低(P<0.05),且治疗组降低优于对照组(P<0.05)。结论酒肝消方联合西药治疗酒精性肝炎疗效确切。

Objective To observe the clinical effect of Jiuganxiao formula combined with western medicine on alcoholic hepatitis. Methods 100 patients with alcoholic hepatitis were randomly divided into two groups. 48 patients in control group were treated by western routine treatment. 52 patients in treatment group were treated by Jiuganxiao formula on the basis of control group treatment. The clinical effect was observed 3 months after treatment in two groups. The changes of aspartic transaminase（ AST）,alanine transaminase（ ALT）,gamma- glutamyl transpeptidase（ γ- GT）,prothrombin time（ PT）,hyaluronic acid（ HA）,procollagen type Ⅲ（ PCⅢ）,laminin（ LN）,B- ultrasonography images and CT scan before and after treatment were observed in two groups. Results The total effective in treatment group（ 80. 77%） was superior to that in control group（ 58. 33%,P〈0. 05）. The levels of ALT,AST,γ- GT and PT after treatment were decreased in two groups（ P〈0. 05）,and the decrease in treatment group was lower than that in control group（ P〈0. 05）. The far field echo attenuation,the pipeline structure was not evident,the hepatomegaly and blood flow signals were decreased in treatment group as compared with those in before treatment（ P〈0. 05）. There were statistical significant differences between before and after treatment on the pipeline structure which was not evident and hepatomegaly in control group（ P〈0. 05）. The far field echo attenuation in treatment group was superior to that in control group. Compared the ratio of liver and spleen on CT scan,there was statistical significant difference between before and after treatment on slight and moderate in treatment group（ P〈0. 05）,and there was no statistical significant difference between before and after treatment in control group（ P〈0. 05）. The levels of HA,PCⅢ and LN after treatment were decreased in two groups（ P〈0. 05）,and the decrease in treatment group was superior to that in control group（ P〈0. 05）. Conclusion The combined therapy of Jiuganxiao formula and western medicine has exact effect on the treatment of alcoholic hepatitis.