CAJ | 학술논문

目的：观察扶正化瘀胶囊联合熊去氧胆酸胶囊对原发性胆汁性肝硬化（PBC）患者症状、血清细胞因子、免疫相关指标的影响。方法选择PBC患者60例，随机分为实验组及对照组各30例。实验组给予扶正化瘀胶囊联合熊去氧胆酸胶囊口服，对照组单用熊去氧胆酸胶囊口服，疗程均为24周。记录并分析治疗12、24周患者中医临床症状、抗线粒体抗体（AMA）、抗线粒体抗体-M2亚型（AMA-M2）、免疫球蛋白G（IgG）、免疫球蛋白M（IgM）、免疫球蛋白A（IgA）、免疫球蛋白B（IgB）、碱性磷酸酶（ALP）、γ-谷氨酰转肽酶（GGT）、ALT、AST、TBil及总胆固醇（CH）、甘油三酯（TG）等各项指标的变化。结果两组患者在治疗12、24周ALT、AST、TBil、ALP、GGT、TG、CH、AMA、AMA-M2、IgM与治疗前组内比较均改善显著，差异均有统计学意义（P均＜0.05）；而IgA、IgB、IgG与治疗前组内比较均无明显改善，差异均无统计学意义（P均＞0.05）。实验组治疗12、24周中医临床症状较前明显改善，而对照组治疗12周中医临床症状无改善，治疗24周中医临床症状略有改善，但治疗前后差异无统计学意义（P ＞0.05）。实验组治疗12、24周中医临床症状、ALP、GGT、ALT、AST、TG、AMA-M2均较对照组明显改善，差异均有统计学意义（P均＜0.05），而实验组治疗12周AMA、IgM及TBil与治疗前比较略有下降，但与对照组比较差异无统计学意义（P均＞0.05）。实验组治疗24周中医临床症状、ALP、GGT、ALT、AST、TG、AMA-M2较对照组均有显著下降，差异有统计学意义（P ＜0.05）。结论熊去氧胆酸胶囊联合扶正化瘀胶囊治疗PBC，在改善中医临床症状、转氨酶及线粒体抗体方面较单纯使用熊去氧胆酸胶囊有明显疗效，但对降低CH、lgA、IgB、IgG无显著作用。
목적：관찰부정화어효낭연합웅거양담산효낭대원발성담즙성간경화（PBC）환자증상、혈청세포인자、면역상관지표적영향。방법선택PBC환자60례，수궤분위실험조급대조조각30례。실험조급여부정화어효낭연합웅거양담산효낭구복，대조조단용웅거양담산효낭구복，료정균위24주。기록병분석치료12、24주환자중의림상증상、항선립체항체（AMA）、항선립체항체-M2아형（AMA-M2）、면역구단백G（IgG）、면역구단백M（IgM）、면역구단백A（IgA）、면역구단백B（IgB）、감성린산매（ALP）、γ-곡안선전태매（GGT）、ALT、AST、TBil급총담고순（CH）、감유삼지（TG）등각항지표적변화。결과량조환자재치료12、24주ALT、AST、TBil、ALP、GGT、TG、CH、AMA、AMA-M2、IgM여치료전조내비교균개선현저，차이균유통계학의의（P균＜0.05）；이IgA、IgB、IgG여치료전조내비교균무명현개선，차이균무통계학의의（P균＞0.05）。실험조치료12、24주중의림상증상교전명현개선，이대조조치료12주중의림상증상무개선，치료24주중의림상증상략유개선，단치료전후차이무통계학의의（P ＞0.05）。실험조치료12、24주중의림상증상、ALP、GGT、ALT、AST、TG、AMA-M2균교대조조명현개선，차이균유통계학의의（P균＜0.05），이실험조치료12주AMA、IgM급TBil여치료전비교략유하강，단여대조조비교차이무통계학의의（P균＞0.05）。실험조치료24주중의림상증상、ALP、GGT、ALT、AST、TG、AMA-M2교대조조균유현저하강，차이유통계학의의（P ＜0.05）。결론웅거양담산효낭연합부정화어효낭치료PBC，재개선중의림상증상、전안매급선립체항체방면교단순사용웅거양담산효낭유명현료효，단대강저CH、lgA、IgB、IgG무현저작용。
Objective To evaluate effect of observed serum cytokines between Fuzhenghuayu and joint capsule ursodeoxycholic acid capsules for primary biliary cirrhosis (PBC) in patients with symptoms, immune-related indicators. Methods Total of 60 patients with PBC were randomly divided into experimental group (30 cases) and control group (30 cases). Experimental group received capsules combined Fuzhenghuayu ursodeoxycholic acid capsules orally, the control group UDCA capsules orally. Patients in both groups were treated for 24 weeks. Record and analyze treatment 12 weeks and 24 weeks of patients with symptoms of clinical medicine, anti-mitochondrial antibody (AMA), anti-mitochondrial antibody-M2 subtype (AMA-M2), immunoglobulin G (IgG), immunoglobulin M (IgM), immune immunoglobulin A (IgA), immunoglobulin B (IgB), alkaline phosphatase (ALP), γ-glutamyl peptidase (GGT), ALT, AST, TBil and total cholesterol (CH), triglycerides change (TG) and other indicators. Results After 12 weeks and 24 weeks of treatment, two groups of ALT, AST, TBil, ALP, GGT, TG, CH, AMA, AMA-M2, the IgM before treatment group were improved significantly, the differences were statistically significant (P < 0.05); while IgA, IgB, the IgG before treatment group showed no signiifcant improvement, the difference was not statistically signiifcant (P>0.05). In the experimental group therapy TCM clinical symptoms improved signiifcantly in the 12 weeks and 24 weeks, but over the prior 12 weeks of treatment in the control group did not improve symptoms of clinical medicine, Chinese medicine treatment of 24 weeks of clinical symptoms improved slightly, but no signiifcant difference before and after treatment (P>0.05). In the experimental group therapy TCM clinical symptoms, ALP, GGT, ALT, AST, TG, AMA-M2 signiifcant improvement compared with the control group, the differences were statistically signiifcant (P<0.05) in the 12 weeks and 24 weeks, while the experimental group was treated for 12 weeks AMA, IgM and TBil declined slightly compared with before treatment, compared with control group, but the difference was not statistically significant (P > 0.05). When the treatment in the experimental group TCM clinical symptoms, ALP, GGT, ALT, AST, TG, AMA-M2 compared with the control group were signiifcantly decreased, the difference was statistically signiifcant (P<0.05) in the 24 weeks. Conclusions Fuzhenghuayu capsule combined with ursodesoxycholic acid take better effect than single ursodesoxycholic acid to PBC in symptom, ALP, GGT, ALT, AST, TG, AMA, AMA-M2, IgM, TBil, but have no different for the levels of CH, IgA, IgB, IgG.