CAJ | 학술논문

目的：探讨血浆置换联合穴位注射治疗对重型肝炎患者肝纤维化指标的影响。方法：将收治的60例重型肝炎患者随机分为2组：A组29例，在常规内科治疗基础上配合血浆置换术；B组31例，在A组治疗基础上同时给予黄芪注射液足三里穴位注射治疗；观察两组患者治疗后血清透明质酸（HA）、层粘连蛋白（LN）、Ⅳ型胶原（Ⅳ-C）、Ⅲ型前胶原（PCⅢ）4项肝纤维化指标水平的变化情况，并与30例健康体检者（C组）比较。结果：治疗前A、B两组肝纤维化指标水平差异无统计学意义（P＞0．05），但都高于C组（P＜0．001）；治疗后两组各项指标水平均下降，其中B组各项指标下降尤为显著，两组比较差异有统计学意义（P＜0．05或P＜0．001）；B组治疗后与C组比较，Ⅳ-C、PCⅢ两项指标差异无显著性（P＞0．05）。结论：血浆置换联合黄芪足三里穴位注射治疗能有效改善重型肝炎患者肝纤维化指标，从而改善患者预后。
목적：탐토혈장치환연합혈위주사치료대중형간염환자간섬유화지표적영향。방법：장수치적60례중형간염환자수궤분위2조：A조29례，재상규내과치료기출상배합혈장치환술；B조31례，재A조치료기출상동시급여황기주사액족삼리혈위주사치료；관찰량조환자치료후혈청투명질산（HA）、층점련단백（LN）、Ⅳ형효원（Ⅳ-C）、Ⅲ형전효원（PCⅢ）4항간섬유화지표수평적변화정황，병여30례건강체검자（C조）비교。결과：치료전A、B량조간섬유화지표수평차이무통계학의의（P＞0．05），단도고우C조（P＜0．001）；치료후량조각항지표수평균하강，기중B조각항지표하강우위현저，량조비교차이유통계학의의（P＜0．05혹P＜0．001）；B조치료후여C조비교，Ⅳ-C、PCⅢ량항지표차이무현저성（P＞0．05）。결론：혈장치환연합황기족삼리혈위주사치료능유효개선중형간염환자간섬유화지표，종이개선환자예후。
Objective To investigate the influence of plasma exchange with acupuncture point injection therapy on liver fibrosis indexes in patients with severe hepatitis. Methods Sixty patients with severe hepatitis were randomly divided into group A with 29 cases receiving plasma replacement and group B of 31 cases receiving astragalus injection at Zusanli point in addition to plasma replacement. Changes of liver fibrosis indexes including serum hyaluronic acid (HA), laminin (LN), collagenⅣ(Ⅳ-C), typeⅢpre-collagen (PCⅢ) were observed, which were compared with those from group C with 30 healthy subjects. Results Before treatment, there was no statistical significance in comparison of liver fibrosis index in group A and B (P>0.05), but all the indexes were higher than those in group C (P<0.001). After treatment, the level of each index in group A and B was down with a more significant change in group B and the comparison of both groups indicated statistical significance (P<0.05 or P <0.001);Compared with those in group C, changes ofⅣ-C, PCⅢin group B showed no significant difference (P>0.05). Conclusion Plasma exchange with astragalus injection at Zusanli point can effectively improve liver fibrosis indexes in patients with severe hepatitis and then improve the prognosis of patients.