柴胡疏肝散加减对肝郁脾虚型肝硬化代偿期肝功能及肝纤维化的影响

The Influence of Modified Bupleurum Liver-Soothing Powder on Liver Function and Liver Fibrosis in the Compensatory Phase of Cirrhosis with Liver Depression and Spleen Deficiency Syndrome

目的:观察柴胡疏肝散加减对肝郁脾虚型肝硬化代偿期患者肝功能及肝纤维化的影响。方法:将60例肝硬化代偿期患者按照随机数字表法分为观察组和对照组,每组各30例。对照组口服恩替卡韦片,观察组在对照组给药的基础上联合柴胡疏肝散加减治疗。比较两组患者的临床疗效及治疗前后肝功能指标[白蛋白(albumin,ALB)、总胆红素(totalbilirubin,TBIL)、谷丙转氨酶(alanine transaminase,ALT)、谷草转氨酶(aspartateaminotransferase,AST)]、肝纤维化指标[透明质酸(hyaluronic acid,HA)、层粘连蛋白(laminin,LN)、Ⅲ型前胶原(procollagen typeⅢ,PcⅢ)、Ⅳ型胶原(typeⅣcollagen,Ⅳ-C)]、肝脾彩超(肝门静脉主干内径、脾脏厚度、脾脏长度)变化情况。结果:观察组有效率为96.7%,对照组有效率为66.7%,两组患者有效率比较,差异具有统计学意义(P<0.05)。两组患者治疗后ALT、AST、TBil低于本组治疗前,ALB高于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。两组患者治疗后HA、PcⅢ、Ⅳ-C、LN低于本组治疗前,且治疗后观察组低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后肝门静脉内径、脾厚度、脾长度低于本组治疗前,且治疗后观察组低于对照组,差异具有统计学意义(P<0.05)。结论:柴胡疏肝散加减治疗肝郁脾虚型肝硬化代偿期,可改善患者的临床症状及肝功能,延缓肝纤维化进程。

Objective:To observe the influence of Modified Bupleurum Liver-Soothing Powder on liver function and liver fibrosis in the compensatory phase of cirrhosis with liver depression and spleen deficiency syndrome.Methods:A total of 60 patients with cirrhosis in the compensatory phase were randomly divided into the observation group and the control group according to the random number table method,with 30 cases in each group.The control group took Entecavir Tablets orally,while the observation group was treated with Modified Bupleurum Liver-Soothing Powder on the basis of the control group.The clinical efficacy,and changes in liver function indexes[including albumin(ALB),total bilirubin(TBIL),alanine Transaminase(ALT),and Aspartic acid Transaminase(AST)],liver fibrosis indexes[including hyaluronic acid(HA),laminin(LN),procollagen type Ⅲ(PcⅢ),and type Ⅳ collagen(Ⅳ-C)],liver and spleen color ultrasound(including the diameter of main stem of Portal vein,thickness of the spleen,and length of the spleen)of the two groups before and after treatment were compared.Results:The effective rate of the observation group was 96.7%,while that of the control group was 66.7%.The difference between the two groups was statistically significant(P<0.05).After treatment,the ALT,AST,and TBil levels of the two groups were lower than those of the same group before treatment,while the ALB level was higher than that before treatment,and all the differences between the two groups were statistically significant(P<0.05);The HA,PcⅢ,Ⅳ-C,and LN of the two groups were lower than those of the same group before treatment,and the observation group's above indexes were lower than those of the control group,and all the differences between the two groups were statistically significant(P<0.05);The inner diameter of Portal vein,the thickness and the length of the spleen in the two groups were lower than those of the same group before treatment,and the observation group's above indexes were lower than those of the control group,and all the differences between the two groups were statistically significant(P<0.05).Conclusion:Modified Bupleurum Liver-Soothing Powder can improve the clinical symptoms and liver function of patients with liver depression and spleen deficiency syndrome in the compensatory phase of cirrhosis,and delay the process of liver fibrosis.