基于“肠-肝轴”肠道菌群调节观察当归芍药散加味治疗肝硬化的临床疗效

Effect Observation on Modified Danggui Shaoyao San in Treating Liver Cirrhosis Based on “Intestine-Liver Axis”

目的:研究基于"肠-肝轴"肠道菌群调节观察当归芍药散加味治疗肝硬化的临床疗效。方法:选取2014年3月至2016年3月广西中医药大学第一附属医院收治的肝硬化患者50例。根据不同治疗方式分为观察组30例,对照组20例,其中对照组患者予以常规西医治疗,观察组患者则在对照组的基础上加用当归芍药散治疗。2组均连续治疗1个月。比较2组临床治疗疗效,Chid-Pugh分级情况,治疗前后肝功能指标水平变化情况以及治疗前肠道菌群变化情况。结果:观察组患者治疗总有效率为86.67%(26/30),高于对照组的60.00%(12/20),差异有统计学意义(P<0.05)。治疗后观察组患者Chid-Pugh分级为A级的人数占比为60.00%(18/30),高于对照组的30.00%(6/20),差异有统计学意义(P<0.05)。治疗后观察组患者的ALT及TBIL水平分别为(68.9±13.2)U/L、(49.3±5.0)μmmol/L,均低于对照组的(112.7±13.5)U/L、(61.4±5.4)μmmol/L(P<0.05)。治疗后观察组患者双歧杆菌水平高于对照组,而大肠杆菌水平低于对照组,差异有统计学意义(P<0.05)。结论:当归芍药散加味治疗肝硬化的主要作用机制可能与改善肠道菌群失调,修复肠道黏膜屏障以及减轻内毒素血症等有关。

Objective： To observe the clinical effect of modified Danggui Shaoyao San in the treatment of liver cirrhosis based on＂Intestine-liver axis＂. Methods： Selected fifty cases of patients with liver cirrhosis admitted in our hospital from March 2014 to March 2016. Then divided patients into observation group and control group,with 30 cases in control group and 20 cases in observation group. Routine western medicine was given the control group,and on the basis of that,the observation group of patients were also treated with Bangui Shaoyao San. Both groups were treated for 1 month. Compare the clinical curative effect,Chid-Pugh,grading,liver function index before and after the treatment of the two groups,as well as the changes of the level and changes of intestinal flora before and after treatment. Results： The total effective rate of the observation group was 86. 67%（ 26/30）,higher than that of the control group 60. 00%（ 12/20）（ P 0. 05）. After treatment,Chid-Pugh A class in the observation group is 60. 00%（ 18/30）,higher than that of the control group 30. 00%（ 6/20）（ P 0. 05）. After treatment,ALT and TBIL levels in the observation group are（ 68. 9 ± 13. 2） U/L,（ 49. 3 ± 5. 0） μmmol/L,lower than those of the control group（ 112. 7 ± 13. 5） U/L,（ 61. 4± 5. 4） μmmol/L（ P 0. 05）. After treatment,bifidobacteria level of the observation group is higher than the control group,and e. coli level is lower than the control group（ P 0. 05）. Conclusion： The mechanism of Danggui Shaoyao San may be related to intestinal flora balance improvement,intestinal mucosal barrier restrore and endotoxin relievement.