基于肝脏病理组织学评价内外同治法抗肝纤维化的临床研究

Clinical Efficacy of Internal and External Therapy Against Liver Fibrosis Evaluated Based on Histopathology of the Liver

目的通过对肝组织学的改善作用观察"内外同治"法抗肝纤维化的临床疗效。方法 51例完成2次肝组织活检的早期肝硬化患者随机分为治疗组和对照组,两组患者均给予常规保肝抗病毒治疗,治疗组在常规治疗基础上以"内外同治"方法,内服抗肝纤维化经验方"柴附莱菔三仙汤",外敷"活血软肝散"进行治疗;对照组在常规治疗基础上加用安络化纤丸进行治疗。两组疗程均为24周。观察两组患者治疗前后肝组织学的变化情况。结果 (1)肝组织炎症改善情况:治疗组治疗前后自身比较肝组织改善明显,差异有统计学意义(P<0.05);而两组治疗后比较也以治疗组改善明显,差异有统计学意义(P<0.05)。(2)肝组织纤维化改善情况:治疗组自身比较,较治疗前差异有统计学意义(P<0.05);两组治疗后比较尤以治疗组改善明显,差异有统计学意义(P<0.05)。(3)两组计分情况比较:以治疗组改善明显,差异有统计学意义(P<0.05)。结论 "内外同治"法对纤维化肝组织有明显改善作用。

Objective To observe the clinical efficacy of"internal and external therapy"against liver fibrosis based on the improvement in liver histology.Methods A total of51patients with early liver cirrhosis who had completed two liver biopsies were randomly divided into treatment group and control group.Both groups were given conventional antiviral treatment for liver protection.In addition to the conventional treatment,the treatment group received"internal and external therapy"-oral administration of experienced prescription of"Chaifu Laifu Sanxian Decoction"against liver fibrosis and external application of"Huoxue Ruangan Powder",while the control group received Anluo Huaxian Pill.The course of treatment was24weeks for both groups.The changes in liver histology after treatment were evaluated in both groups.Results(1)Improvement in liver inflammation:after treatment,the treatment group had a significant improvement in liver inflammation(P<0.05);the treatment group had a significantly more improvement in liver inflammation than the control group(P<0.05).(2)Improvement in liver fibrosis:after treatment,the treatment group had a significant improvement in liver fibrosis(P<0.05);the treatment group had a significantly more improvement in liver fibrosis than the control group(P<0.05).(3)Comparison of score between the two groups:after treatment,the treatment group had a significantly more improvement in score than the control group(P<0.05).Conclusion"Internal and external therapy"can significantly improve liver fibrosis.