白芍总苷胶囊在干燥综合征合并原发性胆汁性肝硬化中对肝功能的保护作用

Protective effect of total glucosides of paeony capsule on liver function in Sjogren's syndrome with primary biliary cirrhosis

目的探讨白芍总苷胶囊在干燥综合征(SS)合并原发性胆汁性肝硬化(PBC)中对肝功能的保护作用。方法前瞻性选取安徽省立医院于2016年1月至2020年1月收治的SS合并PBC患者80例,依据随机数字表法分为观察组40例与对照组40例。对照组给予醋酸泼尼松片及熊去氧胆酸胶囊治疗,观察组在对照组基础上结合白芍总苷胶囊治疗,疗程6个月。比较2组患者治疗6个月的总有效率,治疗前与治疗6个月的黄疸、肝区不适和乏力症状积分及肝功能指标[丙氨酸氨基转移酶(ALT)、谷氨酰转肽酶(GGT)、天门冬氨酸氨基转移酶(AST)]和肝纤维化指标[层粘连蛋白(LN)、三型前胶原N端肽(PC-Ⅲ)和四型胶原(Ⅳ-C)]变化。结果观察组治疗6个月总有效率92.50%高于对照组70.00%,差异有统计学意义(P<0.05)。治疗前2组患者黄疸、肝区不适和乏力症状积分及肝功能和肝纤维化指标比较,差异无统计学意义(P>0.05)。治疗6个月,观察组黄疸积分(0.87±0.15)分、肝区不适积分(1.02±0.32)分和乏力积分(0.78±0.17)分低于对照组[(1.69±0.32)、(1.78±0.24)、(1.54±0.25)分],差异有统计学意义(P<0.05)。治疗6个月,观察组血清ALT(98.42±10.54)U/L、GGT(196.52±13.24)U/L和ASL(89.32±10.36)U/L低于对照组[(117.42±13.62)、(273.21±19.84)、(104.27±13.67)U/L],差异有统计学意义(P<0.05)。治疗6个月,观察组血清LN(124.32±12.19)μg/L、PC-Ⅲ(128.93±12.08)μg/L和Ⅳ-C(108.94±13.24)μg/L低于对照组[(138.21±10.73)、(156.42±16.48)、(137.93±15.65)μg/L],差异有统计学意义(P<0.05)。结论白芍总苷胶囊治疗SS合并PBC患者疗效良好,且具有良好保护患者肝功能作用,值得临床借鉴。

Objective To investigate the protective effect of total glucosides of paeony capsule on liver function in Sjogren's syndrome(SS)with primary biliary cirrhosis(PBC).Methods The 80 patients with SS combined with PBC in Anhui Provincial Hospital from January 2016 to January 2020 were selected and divided into observation group(40 cases)and control group(40 cases)according to the random number table method.The control group was given prednisone acetate tablets and ursodeoxycholic acid capsules,and the observation group was treated with total glucosides of paeony capsule on the basis of the control group.The course of treatment was 6 months.The total effective rate of the two groups after 6 months of treatment was compared.The scores of jaundice,liver discomfort and fatigue symptoms,liver function[alanine aminotransferase(ALT),glutamyl transpeptidase(GGT),aspartate aminotransferase(AST)]and liver fibrosis[laminin(LN),typeⅢprocollagen N-terminal peptide(PC-Ⅲ)and typeⅣcollagen(Ⅳ-C)]were compared between the two groups before and after 6 months of treatment.Results The effective rate observation group(92.50%)was higher control group(70.00%),the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in the scores of jaundice,liver discomfort and fatigue symptoms,liver function and liver fibrosis in the two groups(P>0.05).The jaundice score(0.87±0.15)points,liver discomfort score(1.02±0.32)points and fatigue score(0.78±0.17)points in the observation group were lower control group[(1.69±0.32),(1.78±0.24)and(1.54±0.25)points],the differences were statistically significant(P<0.05).After 6 months of treatment,serum ALT,GGT and ASL in observation group[(98.42±10.54)U/L,(196.52±13.24)U/L,(89.32±10.36)U/L]were lower than those in the control group[(117.42±13.62),(273.21±19.84)and(104.27±13.67)U/L],the differences were statistically significant(P<0.05).After 6 months of treatment,serum LN(124.32±12.19)μg/L,PC-Ⅲ(128.93±12.08)μg/L andⅣ-C(108.94±13.24)μg/L in the observation group were lower than those in the control group[(138.21±10.73)μg/L,(156.42±16.48)μg/L and(137.93±15.65)μg],the differences were statistically significant(P<0.05).Conclusion Total glucosides of paeony capsule in the treatment of SS combined with PBC has a good effect,and has a good protection of liver function,which is worthy of clinical reference.