【摘要】：目的:探討四逆散加減對酒精性肝纖維化患者TGF-β、肝纖維化指標及肝功能指標的影響。方法:納入在2010年6月—2015年7月期間在醫(yī)院接受治療的酒精性肝纖維化患者122例,隨機分為對照組和治療組,各61例。兩組患者均口服水飛薊素片,多烯磷脂酰膽堿膠囊。觀察組在此基礎(chǔ)上口服四逆散加減湯劑,水煎煮至200 m L,日1劑,溫服。兩組患者均治療3個月。觀察兩組患者治療前后谷丙轉(zhuǎn)氨酶(ALT)、谷草轉(zhuǎn)氨酶(AST)、總膽紅素(TBIL)、谷氨酰轉(zhuǎn)移酶(GGT)、堿性磷酸酶(ALP)的變化水平;治療前后透明質(zhì)酸(HA)、III型前膠原(PCIII)、IV型膠原(IV-C)、層黏蛋白(LN)的變化水平;觀察兩組患者治療前后血清中金屬蛋白酶組織抑制劑1(TIMP-1)、轉(zhuǎn)化生長因子β1(TGF-β1)的變化水平,記錄治療期間不良反應發(fā)生情況。結(jié)果:治療組總有效率65.57%,對照組總有效率為59.01%,治療組顯著優(yōu)于對照組,差異有統(tǒng)計學意義(P0.05);兩組患者治療前TBIL、ALT、AST、GGT、ALP比較無統(tǒng)計學差異(P0.05);兩組患者治療后各指標均顯著改善,且均具有統(tǒng)計學差異(P0.05);且治療后觀察組各指標改善情況均優(yōu)于對照組,結(jié)果具有統(tǒng)計學差異(P0.05);兩組患者治療前HA、PCIII、IV-C、LN比較無統(tǒng)計學差異(P0.05);兩組患者治療后各指標均顯著改善,且均具有統(tǒng)計學差異(P0.05);且治療后觀察組各指標改善情況均優(yōu)于對照組,結(jié)果具有統(tǒng)計學差異(P0.05);兩組患者治療前TIMP-1、TGF-β1比較無統(tǒng)計學差異(P0.05);兩組患者治療后上述指標均顯著降低,且均具有統(tǒng)計學差異(P0.05);且治療后觀察組的指標改善情況均優(yōu)于對照組,結(jié)果具有統(tǒng)計學差異(P0.05);對照組和治療組在治療中不良反應發(fā)生情況相似,且未出現(xiàn)嚴重的不良反應,差異不具有統(tǒng)計學意義(P0.05)。結(jié)論:四逆散加減湯劑在治療酒精性肝纖維化中具有顯著的臨床療效,并可能是通過降低患者TGF-β1、TIMPs的表達來發(fā)揮作用,且無明顯不良反應發(fā)生,臨床應用安全可靠,具有重要臨床研究價值,值得進一步推廣應用。
[Abstract]:Aim: to study the effect of Sini San on TGF- 尾, liver fibrosis index and liver function index in alcoholic liver fibrosis patients. Methods: 122 patients with alcoholic liver fibrosis who were treated in hospital from June 2010 to July 2015 were randomly divided into control group and treatment group with 61 cases each. Both groups were treated with silymarin tablets and polyene phosphatidylcholine capsules. Observation group on this basis oral Sini San decoction, boiled to 200 mL, 1 dose per day, warm clothing. Both groups were treated for 3 months. Before and after treatment, the changes of alanine aminotransferase (ALT), total bilirubin (TBIL), glutamyltransferase (GGT),) and alkaline phosphatase (ALP) were observed. Changes of hyaluronic acid (HA), III procollagen type (PCIII), IV collagen (IV-C) and laminin (LN) before and after treatment; The serum levels of tissue inhibitor of metalloproteinase 1 (TIMP-1) and transforming growth factor 尾 1 (TGF- 尾 1) were observed before and after treatment. Results: the total effective rate of the treatment group was 65.57 and the total effective rate of the control group was 59.01. The treatment group was significantly better than the control group (P0.05). There was no significant difference in TBIL,ALT,AST,GGT,ALP between the two groups before treatment (P0.05); after treatment, the indexes of the two groups were significantly improved, and there was statistical difference between the two groups (P0.05). After treatment, the improvement of each index in the observation group was better than that in the control group, the results showed statistical difference (P0.05), and there was no significant difference in HA,PCIII,IV-C,LN between the two groups before treatment (P0.05). Two groups of patients after treatment were significantly improved, and have statistical differences (P0.05), and the observation group after treatment were better than the control group, the results were statistically significant (P0.05); There was no significant difference in TIMP-1,TGF- 尾 1 between the two groups before treatment (P0.05), and the above indexes were significantly decreased after treatment between the two groups (P0.05). After treatment, the improvement of the indexes in the observation group was better than that in the control group, and the results were statistically different (P0.05). Control group and treatment group in the treatment of adverse reactions occurred similar, and no serious adverse reactions, the difference was not statistically significant (P0.05). Conclusion: Sini San decoction has a significant clinical effect in the treatment of alcoholic liver fibrosis, and it may play a role by reducing the expression of TGF- 尾 _ 1 and TIMPs in patients, and no obvious adverse reactions occur. The clinical application is safe and reliable. It has important clinical research value and is worthy of further popularization and application.
【作者單位】： 臺州市第一人民醫(yī)院中醫(yī)科;
【分類號】：R259

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