清肝化湿活血汤加减联合茵栀黄颗粒治疗酒精性肝病临床观察

Clinical Observation of Modified Qinggan Huashi Huoxue Decoction Combined with Yinzhihuang Granules in the Treatment of Alcoholic Liver Disease

目的探讨清肝化湿活血汤加减联合茵栀黄颗粒治疗酒精性肝病的临床疗效。方法选取医院2021年3月至2023年3月收治的酒精性肝病患者200例,按随机数字表法分为观察组和对照组,各100例。两组患者均予酒精性肝病的基础治疗,对照组患者加用茵栀黄颗粒,观察组患者在对照组治疗基础上加用清肝化湿活血汤加减。两组患者均治疗12周。结果观察组总有效率为91.00%,显著高于对照组的79.00%(P<0.05)。治疗后,观察组患者肋痛胀满、痞块结坚、乏力纳呆、舌红苔黄的中医证候积分均显著低于对照组(P<0.05);观察组患者的丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、碱性磷酸酶、总胆红素水平均显著低于对照组(P<0.05);观察组患者的肝门静脉血流动力学指标最大流速、平均流速、搏动指数均显著高于对照组(P<0.05),阻力指数显著低于对照组(P<0.05);观察组患者的血清炎性因子白细胞介素17A、前列腺素E_(2)、CXC趋化因子配体13水平均显著低于对照组(P<0.05);观察组患者的欧洲研究与治疗组织生活满意度测定量表(EORTCQLQ-C30)躯体功能、角色功能、社会功能、总体健康评分均显著高于对照组(P<0.05)。治疗期间,观察组和对照组不良反应发生率相当(12.00%比8.00%,P>0.05)。结论清肝化湿活血汤加减联合茵栀黄颗粒治疗酒精性肝病的临床疗效良好,可改善患者的中医证候积分和肝功能、肝门静脉血流动力学指标,降低炎性因子水平,且安全性良好。

Objective To investigate the clinical efficacy of modified Qinggan Huashi Huoxue Decoction combined with Yinzhihuang Granules in the treatment of alcoholic liver disease.Methods A total of 200 patients with alcoholic liver disease admitted to the hospital from March 2021 to March 2023 were selected and randomly divided into the observation group and the control group by the random number table method,with 100 cases in each group.The patients in the two groups were given basic treatment for alcoholic liver disease.On this basis,the patients in the control group were treated with Yinzhihuang Granules,while the patients in the observation group were treated with Yinzhihuang Granules combined with modified Qinggan Huashi Huoxue Decoction.Both groups were treated for 12 weeks.Results The total effective rate in the observation group was 91.00%,which was significantly higher than 79.00%in the control group(P<0.05).After treatment,the scores of traditional Chinese medicine(TCM)syndromes such as rib pain,fullness,firm lumps,fatigue and numbness,and tongue redness and yellow coating in the observation group were significantly lower than those in the control group(P<0.05);the levels of alanine aminotransferase(ALT),glutamic oxalic aminotransferase(GST),alkaline phosphatase(ALP)and total bilirubin(TBiL)in the observation group were significantly lower than those in the control group(P<0.05);the maximum velocity(V_(max)),average velocity(V_(mea))and pulse index(PI)of hepatic portal vein in the observation group were significantly higher than those in the control group(P<0.05),while the resistance index(RI)in the observation group was significantly lower than that in the control group(P<0.05);the levels of inflammatory cytokines interleukin-17A(IL-17A),prostaglandin E_(2)(PGE_(2))and CXC chemokine ligand 13(CXCL13)in the observation group were significantly lower than those in the control group(P<0.05);the scores of physical function,role function,social function,and overall health in the European Organization for Research and Treatment of Cancer(EORTC)Quality of Life Questionnare-Core 30(EORTC QLQ-C30)in the observation group were significantly higher than those in the control group(P<0.05).During the treatment,the incidence of adverse reactions in the observation group was comparable to that in the control group(12.00%vs.8.00%,P>0.05).Conclusion Modified Qinggan Huashi Huoxue Decoction combined with Yinzhihuang Granules have good clinical efficacy and safety in the treatment of alcoholic liver disease,which can improve the TCM syndrome scores,liver function,and hepatic portal vein hemodynamic indexes,and reduce the level of inflammatory factors of patients.