解毒凉血法保留灌肠对慢性乙型重型肝炎患者血清内毒素、肿瘤坏死因子-α、血氨的影响  

Influence of endotoxin,tumor necrosis factor-alpha and blood ammonia in chronic serious hepatitis B patients through detoxication and cooling blood methods

作　　者：邱梅 陈晶 周大桥 郑颖俊 贺劲松 陈亮 张来 

机构地区：[1]深圳市中医医院肝病科,广东深圳518033

出　　处：《中西医结合肝病杂志》2009年第5期276-277,共2页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

摘　　要：目的:观察解毒凉血法对慢性乙型重型肝炎患者内毒素、肿瘤坏死因子-α(TNF-α)、血氨(NH3)的影响,为中西医结合救治慢性乙型重型肝炎患者提供依据。方法:选择慢性乙型重型肝炎患者62例,随机分为治疗组32例,对照组30例,两组患者均给予综合治疗和血浆置换治疗,治疗组患者加用解毒凉血中药200ml保留灌肠,予对照组患者以同剂量生理盐水保留灌肠,5次/周,连续两周,分别检测血清总胆红素、凝血酶原活动度、内毒素、肿瘤坏死因子-α、血氨的水平。结果:治疗组患者治疗后血清内毒素、TNF-α水平有非常显著降低,与对照组治疗后比较,差异有显著性意义(P<0.01),且TNF-α活性与内毒素水平呈正相关(P<0.01),治疗组患者血清TBil、NH3治疗后下降明显,PTA上升,但与对照组比较,差异无显著性意义(P>0.05)。结论:解毒凉血法对慢性重型肝炎有较好疗效,其机制可能与抑制患者血清内毒素、TNF-α水平有关。Objective： To observe the influence of endotoxin, tumor necrosis factor-alpha （TNF-α） and blood ammonia in chronic serious hepatitis B patients therough detoxication and cooling blood methods, finding a new way of integrated TCM-WN to treat chronic serious hepatitis B. Methods： A total of 62 chronic serious hepatitis B patients were divided into control group （n = 30） and treatment group （n = 32） randomly, all the patients in two groups treated with combined modality therapy and plasma exchange, and treatment group add on detoxication and cooling blood Chinese herbal drugs （200ml） retention enema, the control group only used isodose physiological saline, 5 times a weak and tested the levels of serum total bilirubin, thrombin time, ammonia, endotoxin and tumor necrosis factro-alpha （TNF-α） after two weaks of treatemt. Results： Comapared with control group, the levels of endotoxin and tumor necrosis factor-alpha showed a direct correlation with the level of endotoxin. The levels of serum total bilirubin, thrombin time, ammonia in treatment group were obviously decreased, however, there was no significant difference compared with control group （P 〉 0. 05 ） . Conclusion ： The detoxication and cooling blood methods to treat chronic serious hepatitis B patients suggested a favourable therapeutic effect, and the mechanism may concerned with the inhibition of patients serum endotoxin and tumor necrosis facto-alpha.

关 键 词：慢性乙型重型肝炎 解毒凉血法 内毒素血症 肿瘤坏死因子-Α 

分 类 号：R259[医药卫生—中西医结合]