首 页   本刊简介  编委会  审稿专家  在线期刊  写作规范  广告合作  联系我们
您现在的位置:首页 => 在线期刊 => 2016年 8期 => 其他 =>清肝化湿活血汤联合保肝降酶药物治..
清肝化湿活血汤联合保肝降酶药物治疗酒精性肝病的效果分析
Clinical efficacy of Qinggan Huashi Huoxue decoction combined with liver-protecting and enzyme-lowering drugs in treatment of alcoholic liver disease
文章发布日期:2016年07月06日  来源:  作者:姚志山,刘丁丁,云翔  点击次数:1183次  下载次数:219次

调整字体大小:

(此处下载失败可以在在线预览处保存副本或者右键另存为)

【摘要】:目的观察中药清肝化湿活血汤联合保肝降酶药物治疗酒精性肝病(ALD)的安全性及临床疗效。方法收集2012年1月-2015年12月于唐山市第二人民医院收治的ALD患者175例,随机分为治疗组(n=87)和对照组(n=88)。对照组采用戒酒、营养支持、多烯磷脂酰胆碱、还原性谷胱甘肽、异甘草酸镁、熊去氧胆酸胶囊等治疗,治疗组在对照组治疗方案的基础上加用自拟中药清肝化湿活血汤。治疗3个疗程(12周)的过程中,观察患者的临床症状和体征,并定期复查肝功能(ALT、AST、GGT、白蛋白、TBil)、血脂[总胆固醇、甘油三酯、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)]、血常规、肝脏超声等检测结果,并记录治疗过程中的不良反应。计量资料组间比较采用独立样本t检验,2组间治疗过程中各时间节点差异的比较采用重复测量方差分析,计数资料组间比较采用χ2检验。结果治疗后2组患者的临床症状和体征均得到不同程度的改善,2组间治疗4、8、12周比较差异均有统计学意义(t值分别为14.390、10.487、13.547,P值均<0.05);2组患者的肝功能指标在治疗4、8、12周时均有不同程度改善,2组在治疗4、8、12周时ALT、AST、GGT水平比较差异有统计学意义(F值分别为21.050、8.108、12.038,P值均<0.01);对照组患者HDL水平治疗前后比较,差异有统计学意义(t=3.101,P<0.05),治疗组患者治疗前后HDL、LDL水平比较差异均有统计学意义(t值分别为6.818、2.532,P值均<0.05),2组治疗后HDL水平比较差异有统计学意义(t=2.784,P<0.05);对照组和治疗组的总有效率比较差异有统计学意义(53.4% vs 82.8%,χ2=28.74,P<0.001)。治疗过程中2组患者均未出现明显的不良反应。结论应用中药清肝化湿活血汤联合保肝降酶药物治疗,可改善ALD患者临床疗效,值得临床进一步推广。
【Abstract】:ObjectiveTo investigate the clinical efficacy and safety of Qinggan Huashi Huoxue decoction combined with liver-protecting and enzyme-lowering drugs in the treatment of alcoholic liver disease (ALD). MethodsA total of 175 ALD patients who were admitted to The Second People′s Hospital of Tangshan from January 2012 to December 2015 were enrolled and randomly divided into treatment group (87 patients) and control group (88 patients). The patients in the control group were asked to quit smoking and were given nutritional support and medications including polyene phosphatidylcholine, reduced glutathione, magnesium isoglycyrrhizinate, and ursodeoxycholic acid capsules, and those in the treatment group were given the self-made traditional Chinese medicine Qinggan Huashi Huoxue decoction in addition to the therapeutic regimen for the control group. During the three courses of treatment (12 weeks), the patients′ clinical symptoms and signs were observed, liver function [alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), albumin (Alb), and total bilirubin (TBil)] and blood lipids [total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL)] were performed regularly, the results of routine blood tests and abdominal ultrasound findings were recorded regularly, and adverse events which occurred during treatment were recorded. The independent samples t-test was used for comparison of continuous data between groups, an analysis of variance with repeated measures was used to compare the differences at each time point between the two groups, and the chi-square test was used for comparison of categorical data between groups. ResultsAfter treatment, all patients achieved varying degrees of improvements in clinical symptoms and signs, which showed significant differences between the two groups at weeks 4, 8, and 12 of treatment (t=14.390, 10.487, and 13.547, all P<0.05). The liver function parameters in the two groups showed varying degrees of improvements at weeks 4, 8, and 12 of treatment, and ALT, AST, and GGT showed significant differences between the two groups at weeks 4, 8, and 12 of treatment (F=21.050, 8.108, and 12.038, all P<0.01). In the control group, HDL showed a significant change after treatment (t=3.101, P<0.05), and in the treatment group, HDL and LDL showed significant changes after treatment (t=6.818 and 2.532, both P<0.05). After treatment, HDL showed a significant difference between the two groups (t=2.784, P<0.05). The overall response rate also showed a significant difference between the control group and the treatment group (53.4% vs 82.8%, χ2=28.74, P<0.001). No patient experienced significant adverse events during treatment. ConclusionQinggan Huashi Huoxue decoction combined with liver-protecting and enzyme-lowering drugs can improve the clinical outcome of ALD patients and holds promise for clinical application.
【关键字】:肝疾病, 酒精性; 清肝化湿活血汤; 治疗
【Key words】:liver disease, alcoholic; Qinggan Huashi Huoxue decoction; therapy
【引证本文】:姚志山, 刘丁丁, 云翔. 清肝化湿活血汤联合保肝降酶药物治疗酒精性肝病的效果分析[J]. 临床肝胆病杂志, 2016, 32(8): 1557-1561.

地址:长春市东民主大街519号《临床肝胆病杂志》编辑部 邮编:130061 电话:0431-88782542/3542
临床肝胆病杂志 版权所有 Copyright © 2009 - 2013 Lcgdbzz.org. All Rights Reserv 吉ICP备10000617号

吉公网安备 22010402000041号