基于“主客交”之理论运用加减三甲散治疗肝硬化的临床观察

Observation on Liver Cirrhosis Patients Following Modified Sanjiasan Based on “Blood Vessel and Exogenous Disease Linking” Theory

目的:分析以“主客交”理论为基础采取加减三甲散对肝硬化的效果。方法:选取2019年7月-2020年3月河源市中医院收治的70例肝硬化患者。按随机数字表法分为对照组(常规西医疗法)与治疗组(常规西医疗法+加减三甲散),每组35例。对比两组治疗前后血门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、白蛋白(ALB)、总胆红素(TBIL)、白细胞介素-10(IL-10)、白细胞介素-21(IL-21)、肝功能分级、透明质酸酶(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、Ⅳ型前胶原(C-Ⅳ)、Fibroscan肝脏硬度值(LSM)、天门冬氨酸转移酶与血小板比率指数(APRI)及治疗有效率情况。结果:治疗8周后,治疗组AST、ALT、TBIL、IL-10、IL-21、LSM、APRI、HA、LN、PCⅢ及C-Ⅳ均低于对照组,ALB高于对照组(P<0.05)。观察组治疗8周后肝功能分级优于对照组(P<0.05)。治疗组总有效率高于对照组(P<0.05)。结论:以“主客交”理论为基础采取加减三甲散对肝硬化患者疗效确切,能减轻其肝硬化程度,改善其肝功能、肝纤维化和炎症因子指标,值得采用。

Objective:To analyze the effectiveness of the modified Sanjiasan Chinese medicine prescriptions based on “blood vessel and exogenous disease linking” theory in patients with liver cirrhosis.Method:A total of 70 liver cirrhosis patients treated in eyuan Hospital of Traditional Chinese Medicine from July 2019 to March 2020 were selected.According to random number table,patients were assigned to the control group (western medicine) and the treatment group (western medicine plus modified Sanjiasan Chinese medicine prescriptions),35 cases in each group.The aspartate aminotransferase (AST),alanine aminotransferase (ALT),albumin (ALB),total bilirubin (TBIL),interleukin-10 (IL-10),interleukin-21 (IL-21),Child-Pugh grading,hyaluronic acid (HA),laminin (LN),procollagen type Ⅲ (PC Ⅲ),collagen Ⅳ (C-Ⅳ),fibroscan liver stiffness measurement (LSM),aspartate aminotransferase/platelet ratio index (APRI) and effective treatment rate of two groups were compared.Result:After 8 weeks of treatment the levels of AST,ALT,TBIL,IL-10,IL-21,LSM,APRI,HA,LN,PCⅢ and C-Ⅳ in the treatment group were lower than those in the control group,the level of ALB was higher than that in the control group (P<0.05).The grade of liver function in the treatment group after 8 weeks of treatment was better than that in the control group (P<0.05).The total effective rate in the treatment group was higher than that in the control group (P<0.05).Conclusion:Based on “blood vessel and exogenous disease linking” theory,the modified Sanjiasan can reduce the liver cirrhosis degree,liver fibrosis and inflammatory factors,and improve the liver function,it is worthy of application.