芍药甘草汤加味治疗肝肾阴虚型自身免疫性肝炎疗效分析

Analysis of therapeutic effect of modified Shaoyao Gancao Decoction on autoimmune hepatitis of liver-kidney Yin deficiency type

目的:观察芍药甘草汤加味治疗肝肾阴虚型自身免疫性肝炎(autoimmune hepatitis,AIH)的临床疗效。方法:选取2020年2月—2023年3月辽宁中医药大学附属医院肝病科门诊确诊为肝肾阴虚型AIH患者78例。除去脱落病例后共74例患者,根据随机数字表法分为两组(治疗组39例、对照组35例)。治疗组予芍药甘草汤加味,对照组予口服复方甘草酸苷片,疗程12周。以综合疗效判定标准和中医证候积分改善率为主要疗效指标,以谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷氨酰转移酶(GGT)、球蛋白(GLB)、免疫球蛋白(IgG)抗体水平较基线变化为次要疗效指标。结果:基于西医疗效评价指标,治疗组总有效率为94.87%,对照组总有效率为65.71%。基于中医证候积分改善率,治疗组总有效率为94.87%,对照组总有效率为57.14%。两组治疗后GLB较治疗前降低,且治疗组治疗后GLB低于对照组,差异有统计学意义(P<0.05)。治疗组治疗后IgG较治疗前降低,对照组治疗前后比较,差异无统计学意义(P>0.05)。两组治疗后ALT、AST、GGT均较前降低,但组间比较,差异无统计学意义(P>0.05)。两组治疗过程中,均未见不良反应。结论:芍药甘草汤加味能减轻肝肾阴虚型自身免疫性肝炎患者的临床症状,降低GLB、IgG水平,恢复患者肝功能,并具有长期稳定性及安全性,其效果优于口服复方甘草酸苷片。

Objective:To observe the clinical efficacy of modified Shaoyao Gancao Decoction in the treatment of autoimmune hepatitis(AIH)of liver-kidney Yin deficiency type.Methods:A total of 78 AIH patients with liver-kidney Yin deficiency type diagnosed in the Department of Hepatology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from February 2020 to March 2023 were selected.After removing the shedding cases,a total of 74 patients were divided into two groups according to random number table method(39 cases in the treatment group and 35 cases in the control group).The patients in the treatment group were given modified Shaoyao Gancao Decoction and the patients in the control group were given compound glycyrrhizin tablets.The treatment lasted for 12 weeks.The evaluation criteria of comprehensive efficacy and the improvement rate of TCM syndrome scores were the main efficacy indexes,and the changes of alanine aminotransferase(ALT),aspartate aminotransferase(AST),glutamyltransferase(GGT),globulin(GLB)and immunoglobulin(IgG)antibody levels from baseline were the secondary efficacy indexes.Results:Based on the evaluation index of western medicine,the total effective rate of the treatment group was 94.87%,and the total effective rate of the control group was 65.71%.Based on the improvement rate of TCM syndrome scores,the total effective rate was 94.87%in the treatment group and 57.14%in the control group.GLB after treatment was lower than that before treatment in both groups,and GLB after treatment in the treatment group was lower than that in the control group.The difference was statistically significant(P<0.05).IgG in the treatment group was lower after treatment than that before treatment,and there was no statistical significance in the control group before and after treatment(P>0.05).ALT,AST and GGT were all lower after treatment,but there was no statistical significance between the two groups(P>0.05).No adverse reactions were observed in both groups during treatment.Conclusion:Modified Shaoyao Gancao Decoction can relieve the clinical symptoms of AIH patients with liver-kidney Yin deficiency type,reduce the levels of GLB and IgG,and restore the liver function of patients.And it has long-term stability and safety.Its effect is better than oral compound glycyrrhizin tablets.