四逆散加减对酒精性肝纤维化患者TGF-β、肝纤维化指标及肝功能指标的影响

发布时间：2018-11-19 16:17

【摘要】：目的:探讨四逆散加减对酒精性肝纤维化患者TGF-β、肝纤维化指标及肝功能指标的影响。方法:纳入在2010年6月—2015年7月期间在医院接受治疗的酒精性肝纤维化患者122例,随机分为对照组和治疗组,各61例。两组患者均口服水飞蓟素片,多烯磷脂酰胆碱胶囊。观察组在此基础上口服四逆散加减汤剂,水煎煮至200 m L,日1剂,温服。两组患者均治疗3个月。观察两组患者治疗前后谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、谷氨酰转移酶(GGT)、碱性磷酸酶(ALP)的变化水平;治疗前后透明质酸(HA)、III型前胶原(PCIII)、IV型胶原(IV-C)、层黏蛋白(LN)的变化水平;观察两组患者治疗前后血清中金属蛋白酶组织抑制剂1(TIMP-1)、转化生长因子β1(TGF-β1)的变化水平,记录治疗期间不良反应发生情况。结果:治疗组总有效率65.57%,对照组总有效率为59.01%,治疗组显著优于对照组,差异有统计学意义(P0.05);两组患者治疗前TBIL、ALT、AST、GGT、ALP比较无统计学差异(P0.05);两组患者治疗后各指标均显著改善,且均具有统计学差异(P0.05);且治疗后观察组各指标改善情况均优于对照组,结果具有统计学差异(P0.05);两组患者治疗前HA、PCIII、IV-C、LN比较无统计学差异(P0.05);两组患者治疗后各指标均显著改善,且均具有统计学差异(P0.05);且治疗后观察组各指标改善情况均优于对照组,结果具有统计学差异(P0.05);两组患者治疗前TIMP-1、TGF-β1比较无统计学差异(P0.05);两组患者治疗后上述指标均显著降低,且均具有统计学差异(P0.05);且治疗后观察组的指标改善情况均优于对照组,结果具有统计学差异(P0.05);对照组和治疗组在治疗中不良反应发生情况相似,且未出现严重的不良反应,差异不具有统计学意义(P0.05)。结论:四逆散加减汤剂在治疗酒精性肝纤维化中具有显著的临床疗效,并可能是通过降低患者TGF-β1、TIMPs的表达来发挥作用,且无明显不良反应发生,临床应用安全可靠,具有重要临床研究价值,值得进一步推广应用。
[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.
【作者单位】：台州市第一人民医院中医科;
【分类号】：R259

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