清肝活血方治疗酒精性肝病的临床研究

目的：研究清肝活血方治疗酒精性肝病的临床疗效。方法：采用多中心、随机、对照的方法，将120例酒精性肝病患者分为清肝活血方组(60例，口服清肝活血方)、小柴胡冲剂组(30例，口服小柴胡汤冲剂)、一般治疗组(30例，口服肝泰乐、维生素C)，观察各组患者症状、体征、肝功能、血脂、肝纤维化标志物、细胞因子、脂质过氧化物、B超等的改善情况。结果：清肝活血方组总体疗效，食欲减退、恶心、呕吐、黄疸的改善情况优于其他两组，丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)、甘油三酯(TG)的降低优于其他两组(P<0．01)，γ-谷氨酰转移酶(GGT)、极低密度脂蛋白(VLDL)的降低优于一般治疗组(P<0．01)；清肝活血方并可降低肝纤维化标志物、细胞因子水平，抗肝脏脂质过氧化损伤，较明显改善脂肪肝程度：结论：清肝活血方对酒精性肝病有明显治疗作用，而抗脂质过氧化，稳定肝细胞膜，纠正肝内脂质代谢紊乱，调节免疫功能。抗肝纤维化，促进酒精在肝内代谢的作用可能是其作用机理。

Clinical Study on Treatment of Alcoholic Liver Disease by Qinggan Huoxue Recipe

Objective:To study the effect of Qinggan Huoxue recipe (QGHXR) in treating alcoholic liver disease (ALD). Methods:By adopting the multi-centered, randomized and controlled method, the patients were divided in to the QGHXR group (60 patients) treated orally by QGHXR, the XCHG group (30 patients) treated orally by Xiaochaihu granule and the control group (30 patients) treated orally by conventional therapy such as glucurolactone, vitamin C. The changes in symptoms, signs, liver function, blood lipid, liver fibrosis markers, cytokines, lipid superoxidation parameters and B-untrasonographic figure after treatment of the two groups were observed. Results:The total therapeutic efficacy of QGHXR, improvements in anorexia, nausea, vomiting and jaundice as well as effect in reducing blood levels of alanine transaminase (ALT), aspartate aminotransferase (AST) and triglyceride (TG) were superior in the QGHXR group to those in the other two groups (P<0.01), and the effect in decreasing gamma-glutamyl transferase (GGT) and very low-density lipoprotein (VLDL) in the QGHXR group was more significant than that in the control group (P<0.01). QGHXR also showed effects in lowering levels of liver fibrosis markers and cytokines, alleviating the anti-lipid superoxidation damage in liver, and could markedly improve the degree of fatty liver. Conclusion:QGHXR shows obvious therapeutic effect in treating ALD, the mechanism could possibly be related with its effects in antagonizing lipid superoxidation, stabilizing hepatic cell membrane, adjusting the lipid metabolic disturbance of liver, regulating immune function, anti-liver fibrosis and promoting the intrahepatic metabolism of alcohol.