【摘要】 目的：观察枳葛保肝方配合多烯磷脂酰胆碱治疗酒精性肝病（ALD）湿热内蕴证的临床疗效。方法：纳入2023年11月—2024年11月在浙江中医药大学附属温州市中医院治疗的136例ALD湿热内蕴证患者，使用随机数字表法分为对照组、试验组各68例。对照组予以多烯磷脂酰胆碱胶囊治疗，试验组在对照组基础上加用枳葛保肝方治疗。2组均连续治疗12周。比较2组临床疗效、肝功能指标[碱性磷酸酶（ALP）、γ-谷氨酰基转肽酶（GGT）、总胆红素（TBil）]、酒精性肝炎患者肝纤维化指标[透明质酸（HA）、金属蛋白酶组织抑制因子-1(TIMP-1)、Ⅲ型前胶原（PCⅢ）]及不良反应发生率。结果：治疗12周后，临床疗效总有效率试验组91.93%(57/62)，高于对照组77.78%(49/63)，差异有统计学意义（P<0.05）。2组血清ALP、GGT、TBil水平均较治疗前降低，试验组血清ALP、GGT、TBil水平均低于对照组，差异均有统计学意义（P<0.05）。2组酒精性肝炎患者血清HA、TIMP-1、PCⅢ水平均较治疗前降低，试验组血清HA、TIMP-1、PCⅢ水平均低于对照组，差异均有统计学意义（P<0.05）。不良反应发生率试验组9.68%(6/62)，与对照组4.76%(3/63)比较，差异无统计学意义（P>0.05）。结论：枳葛保肝方配合多烯磷脂酰胆碱治疗ALD湿热内蕴证可提高临床疗效，促进肝功能恢复，减轻肝纤维化，且安全性良好。更多还原

【Abstract】 Objective:To observe the clinical effect of the combination of Zhige Baogan Prescription and Polyene Phosphatidylcholine on alcoholic liver disease(ALD)with internal accumulation of damp-heat syndrome.Methods:A total of 136 ALD patients with internal accumulation of damp-heat syndrome who were admitted to Wenzhou TCM Hospital of Zhejiang Chinese Medical University from November 2023 to November 2024 were included and divided into the control group and the trial group according to the random number table method,with 68 cases in each group. The control group was treated with Polyene Phosphatidylcholine Capsules and the trial group was additionally treated with Zhige Baogan Prescription based on the treatment of the control group. Both groups were treated for 12 weeks. The clinical effects, liver function indexes [alkaline phosphatase(ALP), γ-glutamyl-transpeptidase(GGT)and total bilirubin(TBil)],liver fibrosis indexes [hyaluronic acid(HA),tissue inhibitors of metalloproteinase-1(TIMP-1)and procollagen(PCⅢ)] and incidence of adverse reactions were compared between the two groups.Results:After 12 weeks of treatment,the total clinical effective rate was 91.93%(57/62)in the trial group,higher than that of 77.78%(49/63)in the control group,the difference being significant(P<0.05). The levels of serum ALP,GGT,and TBil in both groups were decreased when compared with those before treatment,and the above three levels in the trial group were lower than those in the control group,differences being significant(P<0.05). The levels of serum HA,TIMP-1,and PCⅢ in both groups of alcoholic hepatitis patients were decreased when compared with those before treatment,and the above three levels in the trial group were lower than those in the control group,differences being significant(P<0.05).The incidence of adverse reactions was 9.68%(6/62)in the trial group and 4.76%(3/63)in the control group,there being no significance in the difference(P>0.05).Conclusion:The combination of Zhige Baogan Prescription and Polyene Phosphatidylcholine can enhance the curative effect on ALD with internal accumulation of damp-heat syndrome,promote the recovery of liver function and reduce liver fibrosis with great safety.更多还原