疏肝利胆活血方联合西药治疗原发性胆汁性肝硬化临床研究

Clinical Study of Shugan Lidan Huoxue Prescription Combined with Western Medicine in Treating PBC

目的:观察疏肝利胆活血方联合熊去氧胆酸胶囊治疗原发性胆汁性肝硬化的临床效果。方法:选择136例原发性胆汁性肝硬化肝胆湿热证患者,按照随机数字表法分为2组各68例。2组患者均口服熊去氧胆酸胶囊,观察组加用自拟疏肝利胆活血方内服,2周为1疗程,连续用药4疗程。比较2组的临床疗效,观察治疗前后肝功能指标[谷草转氨酶(AST)、谷丙转氨酶(ALT)、总胆红素(TBil)、碱性磷酸酶(ALP)、γ-谷氨酰转移酶(GGT)]及血清肝纤维化指标[层黏连蛋白(LN)、透明质酸(HA)、Ⅲ型前胶原(PC-Ⅲ)、Ⅳ型胶原(Ⅳ-C)]的变化。结果:治疗后,总有效率观察组为92.6%,对照组为77.9%,2组比较,差异有统计学意义(P<0.05)。2组肝功能指标AST、ALT、TBil、ALP、GGT均较治疗前下降,观察组各项指标值均低于对照组,差异均有统计学意义(P<0.05)。2组肝纤维化指标LN、HA、PC-Ⅲ、Ⅳ-C均较治疗前下降,观察组各项指标值均低于对照组,差异均有统计学意义(P<0.05)。结论:疏肝利胆活血方联合熊去氧胆酸胶囊治疗原发性胆汁性肝硬化肝胆湿热证患者疗效确切,有利于改善患者的肝功能,降低肝纤维化指标水平。

Objective：To observe the clinical effect of Shugan Lidan Huoxue prescription combined with ursodeoxycholic acid capsule in treating primary biliary cirrhosis（PBC） with wetness-heat of liver and gallbladder syndrome. Methods ：Selected136 patients with PBC,and divided them into two group with 68 cases in each with random table method. The two groups were given oral ursodeoxycholic acid capsule, and the observation group was given Shugan Lidan Huoxue prescription additionally. One course lasted for two weeks,and the treatment lasted for four courses. Compared clinical effect of the two groups, and observed changes of level liver function [aspartate aminotransferase（AST）, total bilirubin（TBil）, Alkaline posphomonoesterase（ALP）,Gamma glutamyl transferase（GGT）],and serum fibrosis index [laminin（LN）,hyaluronic acid（HA）,procollagen type Ⅲ（PC-Ⅲ）,collagen type Ⅳ（Ⅳ-C）] before and after treatment. Results ：After treatment,the total effective rate was 92.6% in the observation group and was 77.9% in the control group,the differences being significant（P〈0.05）. The indexes of liver function,like AST,ALT,TBil,ALP,GGT of the two groups were all lower than those before treatment,and those indexes of the observation group were all lower than those of the control group（P〈0.05）. Levels of fibrosis index,like LN,HA,PC-Ⅲ and Ⅳ-C of the two groups were all lower than those before treatment,and the every index of the observation group was lower than that of the control group（P〈0.05）. Conclusion： Shugan Lidan Huoxue prescription combined with ursodeoxycholic acid capsules has accurate clinical efficacy in treating PBC with wetness-heat of liver and gallbladder syndrome,which can improve liver function of patients and reduce levels of fibrosis index.