针刺配合四君子汤治疗肝硬化的临床研究

Clinical Study on Acupuncture plus Si Jun Zi Decoction in Treating Hepatocirrhosis

目的观察针刺配合四君子汤治疗肝硬化的临床疗效。方法将62例肝硬化患者随机分为治疗组28例和对照组34例。对照组采用常规药物治疗,治疗组在对照组基础上采用针刺配合四君子汤治疗。观察两组治疗前后肝纤维化标志物各项指标[层黏连蛋白质(LN)、透明质酸酶(HA)、Ⅲ型前胶原(PCⅢ)]及消化道症状评分的变化情况,并比较两组治疗后肝功能各项指标[白蛋白(ALB)、总胆红素(TBil)、谷丙转氨酶(ALT)、谷草转氨酶(AST)]、Child-Pugh评分、胃肠道功能恢复情况(肠鸣音恢复时间,反流、呕吐消失时间,每日排便次数)及并发症发生率。结果两组治疗后肝纤维化标志物各项指标(LN、HA、PCⅢ)及消化道症状评分与同组治疗前比较差异均具有统计学意义(P<0.01)。治疗组治疗后肝功能各项指标(ALT、ALB、AST、TBil)、Child-Pugh评分、肝纤维化标志物各项指标、消化道症状评分及胃肠道功能恢复情况与对照组比较差异均具有统计学意义(P<0.01)。治疗组治疗后并发症发生率为10.7%,对照组为38.2%,两组比较差异具有统计学意义(P<0.05)。结论针刺配合四君子汤是一种治疗肝硬化的有效方法,能有效改善患者的肝功能,控制疾病发展,促进胃肠功能恢复,并减少并发症。

Objective To observe the clinical efficacy of acupuncture plus Si jun zi decoction in treating hepatocirrhosis. Method Sixty-two patients with hepatocirrhosis were randomized into a treatment group of 28 cases and a control group of 34 cases. The control group was intervened by conventional medication, while the treatment group was additionally given acupuncture plus Si jun zi decoction. The indicators of liver fibrosis markers [laminin (LN), hyaluronic acid (HA) and type-III procollagen (PCⅢ)] and gastrointestinal symptom score in the two groups were observed before and at the end of the treatment. The indicators of liver function [albumin (ALB), total bilirubin (TBil), alanine transaminase (ALT) and aspartate transaminase (AST)], Child-Pugh score, the recovery of gastrointestinal function (recovery time of bowel sounds, extinction time of regurgitation and vomiting, and daily defecation frequency) and the incidences of complications in the two groups were also compared. Result The indicators of liver fibrosis markers (LN, HA and PCⅢ) and gastrointestinal symptom score all showed a significant change after the treatment in the two groups (P<0.01). After the treatment, the indicators of liver function (ALT, ALB,AST and TBil), Child-Pugh score, the indicators of liver fibrosis markers, gastrointestinal symptom score and the recovery of gastrointestinal function in the treatment group were significantly different from those in the control group (P<0.01). The incidences of complications was 10.7% in the treatment group and 38.2% in the control group, and there was a statistically significant difference between the two groups (P<0.05). Conclusion Acupuncture plus Si jun zi decoction is an effective method in treating hepatocirrhosis. It can effectively improve liver function in the patients, control the development of the disease, promote the recovery of gastrointestinal function, and reduce complications.