自拟调肝活血化瘀方对脾虚血瘀型酒精性肝硬化(代偿期)患者中医证候评分及内毒素水平的影响

Effect of Self-made Tiaogan Huoxue Huayu Recipe on TCM Syndrome Scores and Endotoxin Level in Patients with Spleen Deficiency and Blood Stasis Type of Alcoholic Cirrhosis(Compensatory Stage)

目的:探讨自拟调肝活血化瘀方对脾虚血瘀型代偿期酒精性肝硬化患者中医证候评分及内毒素水平的影响。方法:选取2021年12月至2022年12月我院收治的76例酒精性肝硬化患者,随机分成对照组与观察组,各38例。对照组予以常规西药治疗,观察组基于对照组采用自拟调肝活血化瘀方进行治疗,治疗1个疗程后比较两组临床疗效、中医证候积分、内毒素水平、炎症因子水平、影像学指标水平、肝纤维化指标水平及不良反应发生率。结果:治疗1个疗程后,观察组总有效率高于对照组(94.74%vs 76.32%),差异具有统计学意义(P<0.05);观察组中医证候积分低于对照组,内毒素、白介素-1、肿瘤坏死因子、白介素-6、脾静脉内径、脾脏厚度、肝脏斜径、肝硬度值、层粘连蛋白、Ⅲ型前胶原及IV型胶原水平均低于对照组,差异具有统计学意义(P<0.05);观察组不良反应发生率低于对照组(2.63%vs 18.42%),差异具有统计学意义(P<0.05)。结论:自拟调肝活血化瘀方治疗脾虚血瘀型代偿期酒精性肝硬化疗效较好,可明显改善临床症状,降低中医证候评分,降低内毒素及其他生化指标水平,改善影像学指标,同时具有较高安全性。

Objective:To investigate the effect of self-made Tiaogan Huoxue Huayu Recipe on TCM syndrome scores and endotoxin level in patients with alcoholic cirrhosis(compensatory stage)due to spleen deficiency and blood stasis.Methods:A total of 76patients with alcoholic cirrhosis who were admitted to the hospital from December 2021to December 2022were randomized into a control group and an observation group,with 38patients in each group.The control group was treated with conventional western medicines,while the observation group was treated with self-made Tiaogan Huoxue Huayu Recipe on this basis.All patients underwent a course of treatment.Clinical effects,TCM syndrome scores,endotoxin level,inflammatory factors,imaging indicators,liver fibrosis indicators and the incidence of adverse reactions were compared between the two groups.Results:After a course of treatment,the total response rate in the observation group was higher than that in the control group(94.74%vs.76.32%)(P<0.05).TCM syndrome scores,the levels of endotoxin,interleukin-1,tumor necrosis factor and interleukin-6,diameter of splenic vein,thickness of spleen,oblique diameter of liver,liver stiffness,the levels of laminin,type III procollagen and type IV collagen in the observation group were lower than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group(2.63%vs.18.42%)(P<0.05).Conclusion:Selfmade Tiaogan Huoxue Huayu Recipe is effective in the treatment of alcoholic cirrhosis(compensatory stage)due to spleen deficiency and blood stasis.It can significantly improve clinical symptoms,lower TCM syndrome scores and the levels of endotoxin and other biochemical indicators,and improve the imaging indexes,with high safety.