针刺联合中药治疗原发性胆汁性肝硬化的临床观察

Clinical observation of acupuncture combined with Chinese herbal medicines in the treatment of primary biliary cirrhosis

目的观察针刺联合中药治疗原发性胆汁性肝硬化(primary biliary cirrhosis,PBC)的临床疗效。方法将122例PBC患者采用随机数字表法分为观察组和对照组,每组61例。在基础治疗的同时,对照组采用补虚化瘀方治疗,观察组采用针刺“足三针”联合补虚化瘀方治疗。比较两组治疗前后中医证候积分、肝功能指标[血清碱性磷酸酶(alkaline phosphatase,ALP)、丙氨酸转移酶(alanine aminotransferase,ALT)、天冬氨酸转移酶(aspartate transferase,AST)、γ-谷氨酰转肽酶(gamma-glutamyltransferase,GGT)、总胆红素(total bilirubin,TBIL)]、免疫球蛋白M(immune globulin M,IgM)水平及治疗期间不良反应发生情况。结果两组治疗后中医证候积分均降低,且观察组低于对照组,差异有统计学意义(P<0.05)。两组治疗后血清ALP、ALT、AST、GGT和TBIL水平均降低,且观察组低于对照组,差异有统计学意义(P<0.05)。两组治疗后血清Ig M水平均降低,且观察组低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论在基础治疗的基础上,针刺联合中药治疗PBC可短期内促进患者临床症状缓解,改善肝功能及免疫功能,且具有较高的安全性。

Objective To observe the clinical efficacy of acupuncture combined with Chinese herbal medicines on primary biliary cirrhosis(PBC).Method A total of 122 patients with PBC were divided into observation group and control group by random number table method,with 61 cases in each group.In addition to the basic treatment,the control group was treated with the Buxu Huayu formula,while the observation group was treated with acupuncture at“foot three needles”combined with the Buxu Huayu formula.Before and after treatment,the Chinese medicine syndrome scores,liver function indexes[serum alkaline phosphatase(ALP),alanine aminotransferase(ALT),aspartate transferase(AST),g-glutamyltransferase(GGT),total bilirubin(TBIL)],and immunoglobulin M(IgM)levels in the two groups were compared,and the occurrence of adverse reactions of the two groups during treatment were compared.Result After treatment,the Chinese medicine syndrome scores of the two groups decreased,and those in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of serum ALP,ALT,AST,GGT and TBIL in the two groups were decreased,and those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the serum IgM level of the two groups decreased,and that in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion On the basis of basic treatment,acupuncture combined with Chinese herbal medicines in the treatment of PBC can promote the relief of clinical symptoms,improve liver function and immune function in a short period of time,and has a high degree of safety.