一贯煎组方治疗肝肾阴虚型干燥综合征肝损伤的临床观察及机制

摘要

目的:探究一贯煎组方治疗肝肾阴虚型干燥综合征肝损伤的临床效果及对可能的作用机制.方法:选择96例干燥综合征肝损伤患者随机分为对照组和观察组患者,各48例.对照组患者给予谷胱甘肽静脉滴注,观察组患者则加用一贯煎组方治疗,2周为1个疗程,连续用药4个疗程.比较2组的临床效果,通过Schirmer试验及唾液流率观察口干眼干情况,监测治疗前后血清免疫炎性指标Toll样受体9(TLR9)蛋白浓度、红细胞沉降率(ESR)、免疫球蛋白G(IgG)、C反应蛋白(CRP)水平及肝功能相关指标天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、总胆红素(TBIL)水平变化.结果:观察组有效率为91.7％,显著高于对照组的75％ (P ＜0.05);2组患者经治疗后的Schirmer试验水平及唾液流率水平均有所上升,血清TLR9浓度及ESR、IgG、CRP、AST、ALT、TBIL水平均有所下降,以观察组的变化程度更为明显(P＜0.05).结论:一贯煎组方治疗肝肾阴虚型干燥综合征肝损伤患者疗效肯定,利于改善眼干、口干症状,提高肝功能,其机制与抑制血清中TLR9、ESR、IgG、CRP水平有一定相关性.%Objective:To investigate the efficacy and mechanism of treating liver-kidney yin deficiency type sjogren's syndrome with liver damage by All-Along decoction.Methods:A total of 96 patients were randomly divided into a control group (48 cases) and an observation group (48 cases).Patients in the control group were treated with Glutathione intravenous drip;while patients in the observation group received All-Along decoction treatment on the basis of control treatment.The research was aimed at evaluating the efficacy by comparing its Schirmer's test and salivary flow rate results,and monitoring the levels of TLR9,ESR,IgG,CRP,AST,ALT and TBIL.Results:The effective rate of the observation group was 91.7％,which was higher than that of the control group's 75.0％ (P ＜0.05);The Schirmer's test and salivary flow rate of patients in both two groups after treatment went up,and the levels of TLR9,ESR,IgG,CRP,AST,ALT and TBIL went down compared after the treatment,the degree of the changes in observation group was more significant (P ＜ 0.05).Conclusion:The clinical efficacy of All-Along decoction in treating liver-kidney yin deficiency type sjogren's syndrome with liver syndrome is satisfactory as it can improve the symptoms of dry eyes and dry mouth and liver function,the mechanism may be associated with regulating the levels of TLR9,ESR,IgG and CRP.