摘要
目的观察清肝冲剂与吡喹酮联用治疗血吸虫病肝纤维化的效果。方法收集2018年7月-2020年6月湖南省血吸虫病防治所附属湘岳医院住院的血吸虫病患者,采用病例配对研究方法将其分为对照组(n=62)和观察组(n=62),对照组给予吡喹酮联合九味肝泰胶囊常规治疗,观察组给予吡喹酮联合清肝冲剂抗纤维化治疗,疗程均为4周。比较2组治疗前后血吸虫病肝纤维化声像图分级、透明质酸(HA)和Ⅲ型前胶原肽(PCⅢP)水平、生命质量8项维度指标[生理功能(PF)、生理职能(RP)、躯体疼痛(BP)、总体健康(GH)、生命力(VT)、社会功能(SF)、情感职能(RE)、心理健康(MH)]评分的变化。结果治疗前,2组肝声像图病变分级Ⅲ级占比、HA、PCⅢP、生命质量评分比较差异均无统计学意义(P均>0.05)。治疗后,观察组肝声像图病变分级Ⅲ级占比,HA、PCⅢP水平,生命质量8项维度指标(PF、RP、RE、SF、BP、VT、MH、GH)评分[14.52%、(86.89±12.18)ng/mL、(78.56±10.89)ng/mL、(72.23±11.61)分、(53.08±19.87)分、(41.69±23.32)分、(76.58±13.68)分、(58.11±18.54)分、(62.18±13.23)分、(52.12±13.09)分、(49.65±18.89)分]较治疗前[30.65%、(197.12±15.23)ng/mL、(138.26±11.23)ng/mL、(91.20±12.56)分、(66.56±21.27)分、(58.29±24.62)分、(86.56±21.09)分、(74.25±18.69)分、(71.23±18.59)分、(66.25±16.78)分、(61.85±21.26)分]明显降低,差异均有统计学意义(P均<0.05);且观察组肝声像图病变分级Ⅲ级占比、HA和PCⅢP水平,生命质量8项维度指标中PF、RP、RE、BP、VT、MH评分明显低于对照组[29.03%、(188.80±23.39)ng/mL、(137.41±13.62)ng/mL、(87.00±18.80)分、(61.40±20.90)分、(53.86±26.63)分、(69.68±16.87)分、(67.56±15.54)分、(62.58±12.63)分],差异均有统计学意义(P均<0.05);而对照组除生命质量GH维度评分外,其余各项指标与治疗前比较差异均无统计学意义(P均>0.05)。结论清肝冲剂能降低血吸虫病患者肝纤维化程度,改善生活质量。
Objective To observe the effect of Qinggan granule combined with praziquantel in the treatment of liver fibrosis caused by schistosomiasis.Methods The patients with schistosomiasis disease admitted to the Xiangyue Hospital Affiliated to Hunan Institute of Schistosomiasis Control from July 2018 to June 2020 were collected and divided into the control group(n=62)and the observation group(n=62)by case matching study.The control group was given praziquantel combined with Jiuwei Gantai capsule for routine treatment,and the observation group was given praziquantel combined with Qinggan granule for anti-fibrosis treatment for 4 weeks.The changes in liver fibrosis ultrasound grading,levels of hyaluronic acid(HA)and type Ⅲ procollagen peptide(PCⅢP),and eight dimensional indicators of quality of life[physiological function(PF),role-physical(RP),bodily pain(BP),general health(GH),vitality(VT),social function(SF),role-emotional(RE)and mental health(MH)scores]before and after treatment between two groups of schistosomiasis were compared.Results Before treatment,there were no statistically significant difference in the proportion of liver ultrasound lesion grade Ⅲ,HA,PCⅢP,and quality of life scores between the two groups(all P>0.05).After treatment,the proportion of liver ultrasound lesion gradeⅢin the observation group,the levels of HA and PCⅢP,as well as the scores of eight dimensional indicators of quality of life(PF,RP,RE,SF,BP,VT,MH,GH)[14.52%,(86.89±12.18)ng/mL,(78.56±10.89)ng/mL,(72.23±11.61)score,(53.08±19.87)score,(41.69±23.32)score,(76.58±13.68)score,(58.11±18.54)score,(62.18±13.23)score,(52.12±13.09)score,(49.65±18.89)score]were significantly decreased compared with those of before treatment[30.65%,(197.12±15.23)ng/mL,(138.26±11.23)ng/mL,(91.20±12.56)score,(66.56±21.27)score,(58.29±24.62)score,(86.56±21.09)score,(74.25±18.69)score,(71.23±18.59)score,(66.25±16.78)score,(61.85±21.26)score],and the differences were statistically significant(all P<0.05).Moreover,the proportion of liver ultrasound grade Ⅲ,HA and PCⅢP levels,and eight dimensional indicators of quality of life(PF,RP,RE,BP,VT,MH)in the observation group was significantly lower than those in the control group[29.03%,(188.80±23.39)ng/mL,(137.41±13.62)ng/mL,(87.00±18.80)score,(61.40±20.90)score,(53.86±26.63)score,(69.68±16.87)score,(67.56±15.54)score,(62.58±12.63)score].However,in the control group,except for the GH score of quality of life,there were no significant difference in all other indicators compared to those before treatment(all P>0.05).Conclusion Qinggan Granule could reduce the degree of liver fibrosis and improve the quality of life in patients with schistosomiasis disease.
作者
郑娜
段娟
彭妮娜
江英
何永康
ZHENG Na;DUAN Juan;PENG Nina;JIANG Ying;HE Yongkang(Hunan Institute of Schistosomiasis Control,Yueyang,Hunan 414000,China)
出处
《热带医学杂志》
CAS
2023年第9期1241-1245,共5页
Journal of Tropical Medicine
基金
国家地方病临床重点专科建设项目(卫办医政函[2012]649)
湖南省科技厅专项(湘财教指2008.115)
关键词
血吸虫病
肝纤维化
清肝冲剂
Schistosomiasis
Liver fibrosis
Qinggan granule
作者简介
郑娜(1983-),女,学士,副主任医师,从事消化内科及血吸虫病内科诊治工作,E-mail:9462666@qq.com
