茵栀黄颗粒联合水飞蓟宾胶囊治疗酒精性肝病的疗效观察
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摘要
目的探讨茵栀黄颗粒联合水飞蓟宾胶囊治疗酒精性肝病的临床疗效。方法选取2016年6月—2018年2月广元市第一人民医院收治的120例酒精性肝病患者作为研究对象,所有患者随机分为对照组和治疗组,每组各60例。对照组患者口服水飞蓟宾胶囊,3粒/次,3次/d;治疗组在对照组治疗的基础上口服茵栀黄颗粒,6g/次,3次/d。两组疗程均为12周。观察两组患者临床疗效,比较两组治疗前后的肝功能和肝纤维化指标。结果治疗后,对照组和治疗组的总有效率分别为70.00%、85.00%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清的丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)和谷氨酰转肽酶(GGT)水平均较治疗前显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后治疗组TBIL水平显著低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者血清Ⅲ型前胶原(PC-Ⅲ)、IV型胶原(IV-C)、层黏连蛋白(LN)和透明质酸酶(HA)水平均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后治疗组肝纤维化指标水平显著低于对照组,两组比较差异具有统计学意义(P<0.05)。结论茵栀黄颗粒联合水飞蓟宾胶囊治疗酒精性肝病具有较好的临床疗效,能改善肝功能和肝纤维化,具有一定的临床推广应用价值。
Objective To investigate the clinical efficacy of Yinzhihuang Granules combined with Silibinin Capsules in treatment of alcoholic liver disease. Methods Patients(120 cases) with alcoholic liver disease in the First People's Hospital of Guangyuan from June 2016 to February 2018 were randomly divided into control and treatment groups, and each group had 60 cases. Patients in the control group were po administered with Silibinin Capsules, 3 grains/time, three times daily. Patients in the treatment group were po administered with Yinzhihuang Granules on the basis of the control group, 6 g/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the liver function indexes and the liver fibrosis indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 70.00% and 85.00%, respectively, and there were differences between two groups(P < 0.05). After treatment, the levels of ALT, AST, TBIL, and GGT in two groups were significantly lower than those before treatment, and the difference was statistically significant in the same group(P < 0.05). After treatment, TBIL levels in the treatment group were significantly lower than those in the control group, with significant difference between two groups(P < 0.05). After treatment, the serum PC-Ⅲ, IV-C, LN, and HA levels in two groups were significantly decreased, and the difference was statistically significant in the same group(P < 0.05). After treatment, the levels of liver fibrosis indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups(P < 0.05). Conclusion Yinzhihuang Granules combined with Silibinin Capsules has clinical curative effect in treatment of alcoholic liver disease, can improve liver function and the liver fibrosis, which has a certain clinical application value.
Objective To investigate the clinical efficacy of Yinzhihuang Granules combined with Silibinin Capsules in treatment of alcoholic liver disease. Methods Patients(120 cases) with alcoholic liver disease in the First People's Hospital of Guangyuan from June 2016 to February 2018 were randomly divided into control and treatment groups, and each group had 60 cases. Patients in the control group were po administered with Silibinin Capsules, 3 grains/time, three times daily. Patients in the treatment group were po administered with Yinzhihuang Granules on the basis of the control group, 6 g/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the liver function indexes and the liver fibrosis indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 70.00% and 85.00%, respectively, and there were differences between two groups(P < 0.05). After treatment, the levels of ALT, AST, TBIL, and GGT in two groups were significantly lower than those before treatment, and the difference was statistically significant in the same group(P < 0.05). After treatment, TBIL levels in the treatment group were significantly lower than those in the control group, with significant difference between two groups(P < 0.05). After treatment, the serum PC-Ⅲ, IV-C, LN, and HA levels in two groups were significantly decreased, and the difference was statistically significant in the same group(P < 0.05). After treatment, the levels of liver fibrosis indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups(P < 0.05). Conclusion Yinzhihuang Granules combined with Silibinin Capsules has clinical curative effect in treatment of alcoholic liver disease, can improve liver function and the liver fibrosis, which has a certain clinical application value.
引文
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[12]高华武,陈明,龙子江,等.水飞蓟宾对高脂诱导非酒精性脂肪肝大鼠的调脂保肝作用[J].药物评价研究,2017,40(6):773-777.
[13]谭桢.茵栀黄保护胆汁淤积型肝损伤及其调节胆酸代谢活性的靶向筛选[D].长沙:湖南师范大学,2016.
[14]王欢,谢进,何惠芳,等.茵栀黄颗粒作为肝病辅助用药作用机制的网络药理学研究[J].中国医院用药评价与分析,2016,16(12):1585-1587.
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[2]Sahlman P,Nissinen M,Pukkala E,et al.Incidence,survival and cause-specific mortality in alcoholic liver disease:a population-based cohort study[J].Scand JGastroenterol,2016,51(8):961-966.
[3]中华医学会肝病学分会脂肪肝和酒精性肝病学组,中国医师学会脂肪性肝病专家委员会.酒精性肝病防治指南(2018更新版)[J].现代医药卫生,2018,34(6):959-964.
[4]Federico A,Dallio M,Loguercio C.Silymarin/Silybin and chronic liver disease:a marriage of many years[J].Molecules,2017,22(2):191.
[5]中华医学会肝病学分会脂肪肝和酒精性肝病学组.酒精性肝病诊疗指南(2010年1月修订)[J].胃肠病学,2010,15(10):617-621.
[6]Wu R H,Feng S,Han M,et al.Yinzhihuang oral liquid combined with phototherapy for neonatal jaundice:a systematic review and meta-analysis of randomized clinical trials[J].BMC Complement Altern Med,2018(18):228.
[7]周雄平.茵栀黄对酒精性肝病细胞因子释放的影响及意义[J].临床医药实践,2012,21(5):397-398.
[8]周天萍.茵栀黄口服液联合硫普罗宁治疗药物性肝损伤的临床研究[J].现代药物与临床,2018,33(4):866-870.
[9]孙传兴.临床疾病诊断依据治愈好转标准[M].第2版.北京:人民军医出版社,2002:80-81.
[10]韩婷,井源,吴静,等.酒精性脂肪肝研究现状与进展[J].胃肠病学和肝病学杂志,2008,17(10):862-866.
[11]邵爽,刘春燕,高沿航.水飞蓟宾治疗药物性肝损伤的研究进展[J].临床肝胆病杂志,2017,33(6):1179-1182.
[12]高华武,陈明,龙子江,等.水飞蓟宾对高脂诱导非酒精性脂肪肝大鼠的调脂保肝作用[J].药物评价研究,2017,40(6):773-777.
[13]谭桢.茵栀黄保护胆汁淤积型肝损伤及其调节胆酸代谢活性的靶向筛选[D].长沙:湖南师范大学,2016.
[14]王欢,谢进,何惠芳,等.茵栀黄颗粒作为肝病辅助用药作用机制的网络药理学研究[J].中国医院用药评价与分析,2016,16(12):1585-1587.
[15]赵长普,党中勤,李鲜.茵栀黄颗粒治疗急性黄疸型肝炎的疗效观察[J].西部医学,2010,22(8):1497-1498.