[目的]观察前列腺素E1(PGE1)和中草药联合治疗酒精性肝病(ALD)的临床疗效,并探讨其作用机制。[方法]ALD患者93例随机分为3组:对照组31例(常规治疗);中草药联合治疗(治疗I)组30例(在常规治疗的基础上同时给予中药柴胡等水煎剂,每日1剂);PGE1和中草药联合治疗(治疗Ⅱ)组32例(在治疗I组方案的基础上加用PGE1100μg加入10%葡萄糖250 ml静脉滴注,每日1次),疗程均为1个月。分别观察肝功能、肝纤维化指标及血清细胞因子变化和症状改善情况。[结果]治疗后2治疗组丙氨酸氨基转移酶、天冬氨酸转氨酶、r-谷氨酰转肽酶、总胆红素改善明显,其治疗前后比较及与对照组比较差异均有统计学意义(均P<0.05);2治疗组血清Ⅲ型前胶原和透明质酸水平均明显下降,与对照组比较均P<0.05。治疗Ⅱ组肿瘤坏死因子α(TNF-α)、白细胞介素1(IL-1)I、L-8水平均有明显下降,与对照组比较均P<0.05。[结论]PGE1和中草药治疗ALD疗效显著,其作用机制提示是通过下调患者血清TNF-αI、L-1I、L-8水平,阻止肝细胞坏死及改善肝脏微循环,达到改善肝脏功能,抑制肝纤维化的进展。 [Objective] To observe the clinical efficacy of prostaglandin E1 (PGE1) combined with Chinese herbal medicine in the treatment of alcoholic liver disease (ALD) and to explore its mechanism. [Methods] Ninety patients with ALD were randomly divided into three groups: control group (n = 31) and control group (n = 30) .30 cases were treated with Chinese herbal medicine (group I) Day 1); PGE1 and Chinese herbal medicine combination therapy (treatment Ⅱ) group of 32 patients (in the treatment of group I based on the program plus PGE1100μg plus 10% glucose 250 ml intravenous infusion once daily), a course of treatment were 1 month. Observed liver function, liver fibrosis indicators and serum cytokines and symptoms were improved. [Results] After treatment, the alanine aminotransferase, aspartate aminotransferase, r-glutamyl transpeptidase and total bilirubin were significantly improved in the two treatment groups, with statistical difference before and after treatment and comparison with the control group (All P <0.05). The levels of serum type Ⅲ procollagen and hyaluronic acid in 2 treatment groups were significantly lower than those in control group (all P <0.05). The levels of tumor necrosis factor α (TNF-α) and interleukin-1 (IL-1) I and L-8 in treatment group Ⅱ were significantly decreased compared with those in control group (all P <0.05). [Conclusion] The therapeutic effect of PGE1 and Chinese herbal medicine on ALD is significant. The mechanism of action suggests that by reducing serum TNF-αI, L-1I and L-8 levels, preventing hepatocyte necrosis and improving liver microcirculation, improving liver function and inhibiting liver Progress in fibrosis.