木香顺气散加减治疗肝硬化肝脾肿大临床研究

Clinical Study on Modified Muxiang Shunqi Powder for Hepatic Sclerosis with Hepatosplenomegaly

目的:观察木香顺气散加减治疗肝硬化肝脾肿大的临床疗效及对患者免疫功能和肝纤维化指标水平的影响。方法:选取83例肝硬化肝脾肿大患者,按就诊顺序及随机数字表法分为观察组42例与对照组41例。2组均接受相同的基础治疗和对症治疗,对照组加服恩替卡韦分散片,观察组在对照组基础上加用木香顺气散治疗。比较2组治疗前后中医证候积分、血清CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)、层粘连蛋白(LN)、透明质酸(HA)水平,并评价2组临床疗效。结果:与同组治疗前比较,治疗后2组中医证候积分及PCⅢ、Ⅳ-C、LN、HA水平均降低(P<0.05),CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均升高(P<0.05);与对照组治疗后比较,观察组治疗后中医证候积分及PCⅢ、Ⅳ-C、LN、HA水平均较低(P<0.05),CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均较高(P<0.05)。治疗后观察组总有效率92.86%,高于对照组75.61%(P<0.05)。结论:木香顺气散可有效降低中医证候积分,缓解肝硬化肝脾肿大患者胁肋部疼痛不适等临床症状,同时还能改善患者免疫功能和肝纤维化指标水平,提升治疗有效率。

Objective:To observe the clinical effect of modified Muxiang Shunqi powder for hepatic sclerosis with hepatosplenomegaly and its effects on immune function and levels of liver fibrosis indexes.Methods:A total of 83 cases of patients with hepatic sclerosis with hepatosplenomegaly were selected and divided into the observation group and the control group according to the order of visit and random number table method,with 42 and 41 cases in each group respectively.Both groups were given the same basic treatment and symptomatic treatment.The control group was additionally treated with entecavir dispersible tablets,and the observation group was additionally treated with Muxiang Shunqi powder based on the treatment of the control group.Before and after treatment,Chinese medicine syndrome scores,as well as levels of serum CD3^(+),CD4^(+),CD4^(+)/CD8^(+),typeⅢprocollagen(PCⅢ),typeⅣcollagen(Ⅳ-C),laminin(LN),and hyaluronic acid(HA) were compared between the two groups,and clinical effects were evaluated of the two groups.Results:When compared with those in the same group before treatment,Chinese medicine syndrome scores as well as levels of PCⅢ,Ⅳ-C,LN and HA in the two groups after treatment were decreased(P<0.05),and levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)were increased(P<0.05).After treatment,Chinese medicine syndrome scores as well as levels of PCⅢ,Ⅳ-C,LN and HA in the observation group were lower than those in the control group(P<0.05),and levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)were higher(P<0.05).After treatment,the total effective rate was 92.86%in the observation group,higher than that of 75.61%in the control group(P<0.05).Conclusion:Muxiang Shunqi powder can effectively reduce Chinese medicine syndrome scores,relieve clinica symptoms including costal pain and discomfort in patients with hepatic sclerosis with hepatosplenomegaly,improve their immune function and levels of liver fibrosis indexes,and enhance treatment effective rate.