益气解毒软肝法联合熊去氧胆酸治疗胆汁淤积性肝硬化的疗效观察

摘要

Objective To explore the effect of Yiqijieduruangan method combined with ursodeoxycholic acid on treatment of primary biliary cirrhosis (PBC).Methods Totall 63 PBC patients in Affiliated Hospital of Chengde Medical College from October 2009 to June 2014 were randomly divided into observation group (33 cases) and control group (30 cases).Both the two groups were administrated with symptomatic treatment and ursodeoxycholic acid (250 mg,2 times/d),and the patients in observation group were additionally administrated with Yiqijieduruanganshuijianji method (one dose of Chinese medicine decoction per day,400 ml divided into 2 times,morning and night).Alanine aminotransferase (ALT),aspartate aminotransferase (AST),total bilirubin albumin,albumin and albumin/globulin in blood serum were detected before and three months after treatment and compared between the two groups.Results Three months after treatment,clinical curative effects were observed in both the two groups.The efficiency of observation group was significantly higher than that of control group [81.8％ (27/33) vs 60％ (18/30),P ＜ 0.05].In both groups,ALT,AST and total bilirubin after treatment were significantly decreased,albumin and albumin/globulin were significantly increased compared with pretreatment with statistical differences (P ＜0.05 or P ＜0.01).Significant differences of above indices after treatment between observation group and control group were observed [ALT:(31 ± 8)U/L vs (44 ± 11)U/L,AST:(29 ± 9) U/L vs (43 ± 11) U/L,total bilirubin:(20 ± 3) μmol/L vs (25 ± 3) μmol/L,albumin:(34.8 ± 1.8)g/Lvs (32.9±1.8)g/L,albumin/globulin:(1.6±0.4) vs (1.4±0.4)] (P＜0.05 orP＜0.01).Conclusion Yiqijieduruanganshuijianji method combined with ursodeoxycholic acid can effectively improve the liver function,with preferable effect on treatment of PBC.%目的 探讨益气解毒软肝法联合熊去氧胆酸治疗胆汁淤积性肝硬化(PBC)的疗效.方法 选取2009年10月至2014年6月承德医学院附属医院诊治的63例PBC患者,完全随机分为观察组(33例)和对照组(30例),根据2组患者的病情均给予对症治疗,其中对照组患者给予熊去氧胆酸胶囊250 mg/次,3次/d,口服;观察组患者在同样方法应用熊去氧胆酸治疗的基础上给予益气解毒软肝法组方之中药水煎剂,每日1剂(400 ml),早晚各1次,每次200 ml.治疗3个月后评价疗效,观察2组患者临床治疗有效率及治疗前后2组患者血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、血清总胆红素、白蛋白、白蛋白/球蛋白比值的变化.结果 经过3个月的治疗后,2组患者均有一定的临床疗效,观察组患者的临床有效率为81.8％ (27/33),明显高于对照组的60.0％ (18/30),差异有统计学意义(P＜0.05);2组患者治疗后ALT、AST和总胆红素均较治疗前明显下降,白蛋白、白蛋白/球蛋白比值均较治疗前上升,差异有统计学意义(P ＜0.05或P＜0.01),且治疗后观察组患者的以上指标变化与对照组比较,差异均有统计学意义[ALT:(31±8)U/L比(44±11)U/L、AST:(29 ±9) U/L比(43±11)U/L、总胆红素:(20±3)μmol/L比(25±3)μmol/L、白蛋白:(34.8±1.8)g/L比(32.9±1.8) g/L、白蛋白/球蛋白比值:(1.6±0.4)比(1.4±0.4)](P＜0.05或P＜0.01).结论 益气解毒软肝法联合熊去氧胆酸可以明显改善肝功能,治疗PBC有较好的临床疗效.