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血清谷丙转氨酶(GPT)增高,是慢性肝炎重要的生化指标之一,有不少病人长期或反复异常,甚感精神和肉体上的痛苦。目前用于降酶的方法虽然很多,但有的效果不够满意,有的虽有快速降酶作用,但反跳率较高。我们从临床实践中逐渐体会到,降酶不仅要根据病人全身情况进行中医辨证论治,同时还必须同现代医学有关研究结合起来加以考虑,这样才有助于临床疗效的提高。

英文摘要:

The GPT value in serum,if persistently and repeatedly abnormal,is one of the important biochemical indications in chronic hepatitis.In the treatment of chronic hepatitis by means of TCM-WM,the principle of"Bian Zben Lun Zhi" (辨证论治,diagnosis and treatment should be based on an overall analysis of symptoms and signs,including the cause,nature and location of the illness and the patient’s physical conditions)should take into consideration relevant findings of modern medicine,This paper presents the preliminary results of our practice with some case reports to illustrate our four approaches to the subject. 1.To change the reactivity of the organism:Patients with low value of GPT tend to have skin itching while the liver remains histologically normal or there are only nonspecific inflammatory reactions in it.The inhibition of reactive inflammation by Paeonia suffruticose,Radix Notoginseng,Radix Cynanchi Panieulati,Herba Ajugae and Radix Sophorae Flavescentis,etc.is helpfulin reducing GPT value.For instance,the GPT value of a young female patient had remained 400u or so and HBsAg(+)for 4 years.After administering 24 doses of our prescribed Chinese herbal medicine,her GPT value reduced to normal. 2.To adjust the peripheral pH value of the liver cells:As low pH value at the periphery of the liver cells may reduce the release of GPT,the compound prescription can increase its effectiveness in reducing GPT when Achyranthes Bidentata,Radix Paeoniae Alba,Fructus Crataeig and Fructus Mune,etc.are added to it.After adminstering 14 doses of the Chinese herbal medicine to a young male patient with persistent abnormal GPT value and HBsAg(+)for two years,his GPT value reduced to normal. 3.To enhance the cell-mediated immunity of the organism:Radix Astragali,Fructus Gardeniae,Ramulus Loranthi,Radix Scutellariae,Lonicera japonica.etc.can enhance the functions of cell-mediated immunity.After administering the Chinese herbal medicine for a month or so to a young male patient with abnormal GPT value,HBsAg(+)and subnormal cell-mediated immunity for 9 years,his GPT reduced to normal and cell-mediated immunity recovered.No relapse was found in the following 5 years. 4.To regulate the metabolism of the patient:Many Chinese herbal medicines are effective in correcting metabolic disorders caused by chronic hepatitis,for instance,Cornu Bubali.Radix Notoginseng,Bombyx mori,etc.can increase the level of albumin, while Radix Astragali,Semen Persicae,Achyranthes Bidentata,Angelica Sinesis,Rhizoma Ligustici Wallichii,Radix Salviae Miltiorrhizae can inhibit the production of globulin.A middle-aged male patient with active chronic hepatitis was found that all indications of his liver functions had been abnormal for more than 3 years,such as GPT over 500u,TIT over 20u,A/C =2.8/3.6g% etc.After two and a half months administration oftbe Chinese herbal medicine,herecovered in an all-round way and no relapse occurred for more than one year.

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