中西医结合治疗酒精性肝炎35例疗效观察

目的:观察中西医结合方法治疗酒精性肝炎的临床疗效及机制。方法:将65例酒精性肝炎患者随机分为2组,治疗组35例,在常规西医治疗的基础上,采用清热利湿、行气化瘀中药治疗;对照组30例,采用常规西药治疗。疗程均为8周。观察2组临床疗效与治疗前后外周血白细胞介素-8(IL-8)、超氧化物歧化酶(SOD)、丙二醛(MDA)水平及肝功能变化。结果:治疗组患者外周血IL-8、MDA水平均明显下降(P<0.05,P<0.01),SOD活性明显上升(P<0.05),对照组患者外周血MDA水平明显下降(P<0.05);2组肝功能得到不同程度恢复;2组总有效率比较,差异无显著性意义(P>0.05),但2组显效率比较,差异有显著性意义(P<0.05)。结论:清热利湿、行气化瘀法治疗酒精性肝炎具有较好疗效,其机制可能与中西医结合疗法攻补兼施,抑制炎症细胞因子IL-8水平、减轻肝脏脂质过氧化反应等有关。且无不良反应。

Treatment of Alcoholic Hepatitis by TCM Combined with Western Medicine:A Clinical Observation of 35 Cases

Objective: To observe the curative effect and mechanism of TCM combined with western medicine (WM) for alcoholic hepatitis (AH). Methods: 65 cases of AH were allocated to 2 groups randomly. Treatment group(35 cases) based on routine WM treatment and applied Chinese herbal drugs for clearing heat and damp, promoting qi flow and removing blood - stasis simultaneously; control group (30 cases) by routine WM alone. 8 weeks constituted the course of treatment in both groups. The curative effects, IL - 8 of peripheral blood, SOD, level of MDA and the change of liver function were observed before and after treatment. Results: In treatment group, the IL - 8 and level of MDA were markedly decreased ( P < 0.05, P < 0.01); the activity of was markedly increased (P < 0. 05). In control group, the level of MDA of peripheral blood was markedly decreased ( P < 0. 05). The liver function of both groups were recovered in different degree. The comparison of total effective rates showed no significant difference ( P > 0. 05), but the comparison of markedly effective rate showed markedly significant difference ( P < 0. 05) . Conclusion: Therapy of heat - clearing, damp -dispersing, qi - flow - promoting and blood - stasis - removing possesses good effect for AH. Its mechanism may be related to the therapy of TCM combined with WM can inhibit the level of IL - 8, relieve the peroxidation of liver lipid. No adverse reaction is observed.