世界中医药

目的：探究健脾调肝方联合激素治疗自身免疫性肝炎的疗效及对肝功能的影响。方法：选取2017年1月至2018年5月上海市长宁区天山中医医院收治的自身免疫性肝炎患者72例作为研究对象，随机分为对照组和观察组，每组36例。对照组给予常规对症治疗及激素治疗，观察组在对照组的基础上联合健脾调肝方治疗，2组患者均连续治疗3个月。治疗后统计2组临床疗效及中医证候积分，检测并比较治疗前后2组血清肝功能指标及免疫球蛋白水平变化，记录2组治疗期间不良反应发生情况。结果：治疗后观察组临床疗效总有效率及证候积分疗效总有效率分别为80.56%、91.67%，高于对照组的58.33%、72.22%，差异有统计学意义（P<0.05）；治疗后对照组血清IgG、IgM及IgA水平与治疗前比较，差异无统计学意义（P>0.05）；而治疗后2组血清丙氨酸转氨酶（ALT）、谷草转氨酶（AST）、总胆红素（TBIL）、谷氨酰转肽酶（GGT）、球蛋白（GLB）水平及观察组IgG、IgM、IgA水平均降低，且观察组低于对照组，差异有统计学意义（P<0.05）；2组治疗期间均未见严重不良反应发生。结论：健脾调肝方联合激素治疗可显著改善自身免疫性肝炎患者临床症状，降低血清异常升高的免疫球蛋白含量，并可有效恢复其肝功能且安全性良好，总体疗效优于单独激素治疗。

English Summary:

To explore the clinical efficacy of Jianpi Tiaogan Prescription combined with hormone in the treatment of autoimmune hepatitis and the influence on liver function.Methods:A total of 72 cases of autoimmune hepatitis patients in Shanghai Changning Tianshan Traditional Chinese Medicine Hospital from January 2017 to May 2018 were selected and randomly divided into a control group and an observation group,with 36 cases for each group.The control group was treated with routine symptomatic therapy and hormone therapy,and the observation group was treated combined with Jianpi Tiaogan Prescription on the basis of control group.The 2 groups were treated for 3 months continuously.The clinical efficacy and the traditional Chinese medicine (TCM) syndrome points efficacy in the 2 groups after treatment were evaluated,and the changes of serum liver function indexes and immunoglobulin content in the 2 groups were detected and compared before and after treatment.The occurrence of adverse reaction in the 2 groups during the treatment was recorded.Results:The total clinical effective rate and the total effective rate of TCM syndrome points efficacy in the observation group after treatment were 80.56%,91.67%,which were significantly higher than 58.33%,72.22% in the control group (P<0.05); compared with before treatment,the serum IgG,IgM and IgA contents in the control group after treatment had no significant changes (P>0.05); while the serum ALT,AST,TBIL,GLB,GGT levels in the 2 groups and the IgG,IgM,IgA contents in the observation group decreased significantly,and the observation group was lower than the control group significantly (P<0.05 or P<0.01); no serious adverse reaction occurred during the treatment in the 2 groups.Conclusion:Jianpi Tiaogan Prescription combined with hormone treatment can improve the clinical symptoms of autoimmune hepatitis patients,reduce the serum abnormally elevated immunoglobulin content,restore the liver function effectively and has good safety.The overall efficacy is superior to hormone therapy alone.

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