疸清颗粒治疗肝胆湿热型急性肝内胆汁淤积症

Clinical Efficacy of Danqing Granules in Acute Intrahepatic Cholestasis with Liver-gallbladder Dampness-heat Syndrome

目的:探讨疸清颗粒治疗肝胆湿热证急性肝内胆汁淤积(IC)的临床疗效,并从炎症反应和氧化应激方面探讨了其作用机制。方法:99例符合要求的患者随机按数字表法分为观察组50例和对照组49例。对照组给予常规护肝、降酶等对症治疗,采用口服熊去氧胆酸片,250 mg/次,3次/d;观察组在对照组治疗的基础上加用疸清颗粒,10 g/次,3次/d,两组疗程均为4周。检测治疗前后总胆红素(TBIL),碱性磷酸酶(ALP),γ-谷氨酰转肽酶(GGT),总胆汁酸(TBA),谷氨酸氨基转移酶(ALT),天门冬氨酸氨基转移酶(AST)水平,每周进行肝胆湿热证评分,检测治疗前后肿瘤坏死因子-α(TNF-α),白细胞介素-6(IL-6),IL-1,总超氧化物歧化酶(SOD)和丙二醛(MDA)水平。结果:观察组临床疗效总有效率为92%,高于对照组的75.5%(P<0.05);观察组在第2,3,4周肝胆湿热证评分均低于对照组(P<0.01);治疗后观察组TBIL,ALP,GGT,TBA,ALT和AST水平均低于对照组(P<0.01);治疗后观察组TNF-α,IL-6和IL-1水平均低于对照组(P<0.01);治疗后两组SOD水平较治疗前升高,观察组高于对照组(P<0.01);治疗后两组MDA水平下降,观察组低于对照组(P<0.01)。结论:疸清颗粒在对照组治疗的基础上治疗肝胆湿热证IC,能减轻临床症状,保护肝功能,提高疗效,其作用机制可能是通过减轻炎症损伤和抑制氧化应激来实现的。

Objective： To discuss the clinical efficacy of Danqing granules in treating acute intrahepatic cholestasis（ IC） with liver-gallbladder dampness-heat syndrome, and investigate the action mechanism from inflammatory reaction and oxidative stress. Method： Ninety-nine patients were randomly divided into control group（ 49 cases） and observation group（ 50 cases） by random number table. Patients in control group received conventional liver protection treatment,enzyme reducing treatment and other symptomatic treatment,orally took ursodeoxycholic acid tablets,250 mg / time,3 time / day. Based on the treatment of control group,patients in observation group received additional Danqing granules,10 g / time,3 time / day. The treatment course was 4 weeks for both groups. Before and after treatment,levels of total bilirubin（ TBIL）,alkaline phosphatase（ ALP）,gamma-glutamgtranspeptidaser（ GGT）,total bile acid（ TBA）,alanine aminotransferase（ ALT）,and aspartate aminotransferase（ AST） were detected. Scores of liver-gallbladder dampness-heat syndrome were graded every week. The levels of tumour necrosises factor-α（ TNF-α）,interleukin-6（ IL-6）,interleukin-1（ IL-1）,total superoxide dismutase（ T-SOD）,and malondialdehyde（ MDA） were also detected both before and after treatment.Result： The total effective rate was 92% in observation group,higher than 75. 5% in control group（ P 〈0. 05）. At the second,third and forth week after treatment,scores of liver-gallbladder dampness-heat syndrome in observation group were lower than those in control group（ P 〈0. 01）. After treatment,the levels of TBIL,ALP,GGT,TBA,ALT,AST,TNF-α,IL-6 and IL-1 were lower than those in control group（ P 〈0. 01）. The levels of SOD were increased in both groups after treatment,and the level in observation group was higher than that in control group（ P 〈0. 01）. Levels of MDA were decreased in both groups after treatment,and the level in observation group was lower than that in control group（ P 〈0. 01）. Conclusion： Danqing granules based on the western medicine group can relieve clinical symptoms,protect liver function,and improve effect,and its mechanism of action may relieve inflammatory injury and inhibit oxidative stress.