不同剂量易善复治疗肝纤维化的临床分析-clinical analysis of different doses of yi shanfu in treating hepatic fibrosis.docxVIP

摘要目的：观察不同剂量多烯磷脂酰胆碱注射液（易善复）治疗肝硬化患者用药前后肝功、凝血酶 原时间、血小板计数及肝纤维化四项，探讨药物的近期保护肝细胞及抗纤维化疗效，提供肝 硬化的治疗新方案。方法：将收集我院消化内科 2011 年 4 月至 2012 年 8 月肝硬化患者 60 例，随机分为小剂量对照 组及大剂量治疗组，各 30 例。小剂量组给予易善复 465mg，大剂量组给予易善复注射液 930， 静脉滴注治疗，观察两组肝纤维化指标。结果：1. 肝纤维化四项指标：治疗前，两组间差异无统计学意义(P0.05)。治疗后，各组指标均 有所改善，两组比较，透明质酸及层黏蛋白以大剂量组下降更为明显，两组比较差异有 统计学意义（P0.01）。2. 间接肝纤维化指标：治疗前，两组间差异无统计学意义(P0.05)。治疗后，各组指标均 改善，两组间比较，大剂量组转氨酶、总胆红素和胆固醇改善优于小剂量组，两组差异 具有统计学意义（P0.05）。3. 两组均无不良反应。结论：1. 大剂量易善复改善肝硬化患者的转氨酶、总胆红素、凝血酶原时间、透明质酸及层黏蛋 白优于小剂量。2. 大剂量易善复临床应用中无不良反应，已达到在短时间内控制、稳定病情的效果，相对 缩短住院时间。大剂量易善复疗效明显，值得推广应用。关键字：不同剂量；多烯磷脂酰胆碱；肝纤维化AbstractObjective:To compare the indexes of liver function , prothrombin time, platelet count and Serum Hepatofibrosis between the two groups 10 day later ,that the effects of different doses polyene phosphatidyl choline injection (Essentiale) in the treatment of patients with cirrhosis medication. To explore the efficacy of immediate liver cells protection and anti-fibrosis , as well as the impact of the observed indicators.Method:60 patients with hepatic cirrhosis enrolled in the gastroenterology department from April 2011 to August 2012 were collected and randomly assigned to the treatment group(n=30) treated with high –dose Essentiale 930 mg by intravenous drip and the control group (n=30) treated with low-dose Essentiale 465mg by intravenous drip .The efficacies before and after treatment were observed and compared between the two group.Results:1.Before treatment , direct Serum Hepatofibrosis (serum procollagen type Ⅲ, hyaluronic acid, laminin, collagen type Ⅳ ) did not have significant difference(P 0.05). Aftertreatment ,markers were reduced . hyaluronic acid and laminin,in the high-dose group were more signicant than that in the low-group , the differences had statistical significance (P0.01).Before treatment , indirect Serum Hepatofibrosis (the liver function, serum albumin, platelets) did not have significant difference(P 0.05). After treatment ,markers were improved. the serum alanine