畲药龙斑汤结合多烯磷脂酰胆碱治疗酒精性肝炎患者对其血清leptin及Hcy表达的影响

The effect of She medicine Longban Decoction combined with polyene phosphatidylcholine on the expression of serum leptin and Hcy in the patients with alcoholic hepatitis

目的观察畲药龙斑汤结合多烯磷脂酰胆碱治疗酒精性肝炎的疗效及对患者血清瘦素(leptin)及同型半胱氨酸(Hcy)表达的影响。方法选取70例2018年2月~2019年6月在我院治疗的酒精性肝炎患者,随机分为研究组(35例)和对照组(35例),两组常规治疗相同,对照组予多烯磷脂酰胆碱针,研究组联合畲药龙斑汤。检查所有患者在治疗前及治疗后血清天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、碱性磷酸酶(ALP)、谷氨酰转肽酶(GGT)、总胆红素(TBil)和结合胆红素(DBil)。观察所有患者肺纤维化及影像学变化情况,并比较治疗后及3个月后疗效变化。比较两组治疗前和治疗后leptin和Hcy水平变化。结果治疗后研究组总有效率(97.1%)明显高于对照组(54.3%,P<0.01),3个月后的研究组的总有效率(85.7%)高于对照组(30.0%,P<0.05)。两组治疗后血清AST、ALT、ALP、GGT、TBil和DBil水平均显著降低(P<0.01),且研究组下降更多(P<0.01)。B超结果显示,治疗后研究组管道结构显示不清及肝肿大情况改善(P<0.05)。两组患者治疗后血清leptin和Hcy水平均降低(P<0.05),治疗后研究组血清leptin为(13.9±2.3)μg/L和Hcy为(18.9±5.6)mol/L,较对照组血清leptin为(15.3±3.5)μg/L和Hcy为(29.1±6.8)mol/L水平降低,差异有统计学意义(P<0.05)。结论畲药龙斑汤结合多烯磷脂酰胆碱能改善肝功能及肝纤维化情况,降低血清leptin和Hcy表达水平,提高治疗效果并延长疗效。

Objective To observe the therapeutic efficacy of She medicine Longban Decoction combined with polyene phosphatidylcholine in the treatment of alcoholic hepatitis and the effect on the expression of the patients'serum leptin and homocysteine(Hcy).Methods A total of 70 patients with alcoholic hepatitis treated in our hospital from February 2018 to June 2019 were selected and randomly divided into the study group(n=35)and the control group(n=35).The same conventional treatment was given to the two groups,but on this basis,the control group was only injected polyene phosphatidylcholine,while the study group was additionally given She medicine Longban Decoction.The serum aspartate aminotransferase(AST),alanine aminotransferase(ALT),alkaline phosphatase(ALP),gama-glutamyltransferase(GGT),total bilirubin(TBil)and direct bilirubin(DBil)of all the patients before and after treatment were examined.The changes of hepatic fibrosis and the radiographic changes of all the patients were observed and the therapeutic efficacy was compared after treatment and 3 m later.The levels of leptin and Hcy before and after treatment were compared between the two groups.Results After treatment,the total effective rate(97.1%)of the study group was significantly higher than that of the control group(54.3%,P<0.01),and 3 m later,the total effective rate(85.7%)of the study group was higher than that of the control group(30.0%,P<0.05).After treatment,the levels of serum AST,ALT,ALP,GGT,TBil and DBil in both the two groups decreased significantly(P<0.01),and the decrease in the study group was more significant(P<0.01).The results of type-B ultrasonic tests showed that after treatment the unclear imaging of duct structure and the hepatomegaly of the study group ameliorated(P<0.05).The levels of serum leptin and Hcy of both the two groups of patients after treatment decreased(P<0.05).After treatment,the serum leptin was(13.9±2.3μg/L)and the Hcy was(18.9±5.6 mol/L)of the study group were lower than the serum leptin was(15.3±3.5μg/L)and Hcy was(29.1±6.8 mol/L)of the control group,with statistically significant differences(P<0.05).Conclusion She medicine Longban Decoction combined with polyene phosphatidylcholine can ameliorate liver function and the conditions of hepatic fibrosis,decrease the levels of expression of serum leptin and Hcy,enhance the therapeutic efficacy and prolong the curative effect.