基于临床药效剂量下的栀子大黄汤抗酒精性肝损伤的临床研究OA

Objective To investigate the clinical efficacy of Gardeniae Fructus and Rhei Radix et Rhizoma(Zhizi Dahuang Decoction,ZZDH Decoction)against alcoholic liver injury when administered at a clinically effective dosage.Methods A total of 98 patients with alcoholic liver injury of internal retention of damp-heat type,admitted to the Tenth People's Hospital Affiliated to Tongji University from February 2023 to April 2025 were enrolled as study subjects.Based on patients'intention and treatment modality,they were divided into a control group(47 cases)and a study group(51 cases).The control group received conventional western medicine treatment,while the study group received additional ZZDH Decoction at a clinically effective dosage for 4 weeks.Before and after treatment,both groups were evaluated for traditional Chinese medicine(TCM)syndrome scores,liver function markers,liver fibrosis markers,FibroScan liver stiffness measurements,glucose and lipid metabolism indicators,T lymphocyte subsets,and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC-QLQ-C30)scores.Clinical efficacy was also assessed.Results(1)Efficacy:After 4 weeks of treatment,the total effective rate in the study group was 90.20%(46/51),significantly higher than 72.34%(34/47)in the control group(by chi-square test,P＜0.05).(2)TCM syndrome scores:After treatment,scores for hypochondriac distending pain,poor appetite,nausea and vomiting,yellowish urine,and scleral and cutaneous icterus were significantly decreased in both groups(P＜0.05),with significantly greater reductions in the study group(P＜0.01).(3)Liver function markers:Serum levels of total bilirubin(TBil),bile acid(BA),alanine aminotransferase(ALT),aspartate aminotransferase(AST),and γ-glutamyl transferase(GGT)were significantly reduced in both groups after treatment(P＜0.05),with significantly greater reductions in the study group(P＜0.01).(4)Liver fibrosis markers:Serum levels of laminin(LN),procollagen I N-terminal peptide(PINP),procollagen Ⅲ peptide(Ⅲ-PC),prolyl endopeptidase(PLD),and hyaluronic acid(HA)were significantly decreased in both groups after treatment(P＜0.05),with significantly greater decreases in the study group(P＜0.01).(5)Liver stiffness:Liver stiffness measurement(LSM)and controlled attenuation parameter(CAP)values were significantly reduced in both groups after treatment(P＜0.05),with significantly greater reductions in the study group(P＜0.01).(6)Glucose and lipid metabolism:After treatment,levels of total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),fasting blood glucose(FBG),and homeostatic model assessment of insulin resistance(HOMA-IR)were significantly decreased in both groups(P＜0.05),with significantly greater decreases in the study group(P＜0.01).(7)T lymphocyte subsets:After treatment,the percentages of CD3+,CD4+,and CD4+/CD8+ratio were significantly increased,while CD8+percentage was significantly decreased in both groups(P＜0.05).The study group showed significantly greater improvements in these parameters compared to the control group(P＜0.05 or P＜0.01).(8)Quality of life:After treatment,scores for cognitive function,social function,physical function,and role function dimensions of the EORTC-QLQ-C30 scale were significantly increased in both groups(P＜0.05),with significantly greater increases in the study group(P＜0.01).Conclusion The ZZDH Decoction at clinically effective dosage determined by prior experimental studies significantly alleviates liver fibrosis,reduces liver stiffness,improves liver function,regulates glucose and lipid metabolism,enhances immune function,alleviates clinical symptoms,and improves clinical efficacy and quality of life in patients with alcoholic liver injury of internal retention of damp-heat type,demonstrating promising anti-alcoholic liver injury effect.