银杏叶提取物联合复方甘草酸苷治疗HBV感染慢加急性肝功能衰竭疗效及对外周血NF-κB、TNF-α、LXA4和LPS的影响  

Effect of Ginkgo biloba extract combined with Compound Glycyrrhizin on Hepatitis B virus related acute-onchronic liver failure and its influence on peripheral blood NF-κB,TNF-α,LXA4 and LPS

作　　者：李峥[1] 童旭东[1] LI Zheng, TONG Xudong(Xiangyang Central Hospital, Xiangyang 441021, Hubei, China)

机构地区：[1]湖北省襄阳市中心医院,湖北襄阳441021

出　　处：《现代中西医结合杂志》2018年第21期2315-2318,2387,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的观察银杏叶提取物联合复方甘草酸苷治疗HBV感染慢加急性肝功能衰竭(HBV-ACLF)的疗效及对外周血核因子-κB(NF-κB)、肿瘤坏死因子-α(TNF-α)、脂氧素A4(LXA4)和内毒素(LPS)的影响。方法将60例HBV-ACLF患者随机分为对照组和观察组,每组30例。2组均采取常规西医治疗(抗病毒+保肝+营养支持+血浆置换等),在常规治疗基础上对照组给予复方甘草酸苷注射液治疗,观察组在对照组治疗基础上给予银杏叶提取物注射液治疗,疗程2个月。观察2组治疗前后临床症状体征、肝功能、营养状态、凝血功能情况,记录MELD评分、Child-Pugh改良分级评分变化,检测2组治疗前后血浆NF-κB、TNF-α、LXA4和LPS水平,并记录2组临床结局。结果 2组治疗后恶心呕吐、腹胀、腹水、黄疸、乏力、食欲减退、尿少积分均显著降低(P均<0.05),且观察组上述积分均显著低于对照组(P均<0.05);2组治疗后TBil、AST、ALT、GGT、ALB、PA、Plt、PTA均显著改善(P均<0.05),观察组改善情况显著优于对照组(P均<0.05);2组治疗后MELD评分、Child-Pugh改良分级评分均显著降低(P均<0.05),且观察组上述评分均显著低于对照组(P均<0.05);2组治疗后血浆NF-κB、TNF-α、LPS水平显著降低而LXA4水平显著升高(P均<0.05),且观察组上述指标改善情况均优于对照组(P均<0.05);观察组不良结局发生率显著低于对照组(P均<0.05)。结论银杏叶提取物联合复方甘草酸苷能够显著改善HBV-ACLF患者的临床症状,促进肝功能、营养和凝血功能的恢复,并可减少并发症,其机制可能与调节血浆NF-κB、TNF-α、LXA4和LPS的水平有关。Objective It is to observe the effect of Ginkgo biloba extract combined with Compound Glycyrrhizin in the treatment of Hepatitis B virus related acute-on-chronic liver failure（ HBV-ACLF） and the influence of peripheral blood nuclear factor-κB（ NF-κB）,tumor necrosis factor-α（ TNF-α）,lipoxygenin A4（ LXA4） and endotoxin lipopolysaccharide（ LPS）. Methods Sixty patients with HBV-ACLF were randomly divided into control group and observation group,30 cases in each group. The two groups were treated with conventional Western Medicine（ antiviral ＋ liver protection ＋ nutritional support ＋ plasma exchange,etc.）. On the basis of the above conventional treatment,the control group was treated with Compound Glycyrrhizin injection,the observation group was treated with Compound Glycyrrhizin injection combined with Ginkgo Biloba extract injection,the treatment lasted for 2 months. The clinical symptoms and signs,liver function,nutritional status and coagulation function of the two groups before and after treatment were observed,the MELD score and Child-Pugh improved grading score were recorded,the levels of plasma NF-κB,TNF-α,LXA4 and LPS were measured before and after treatment in the two groups,and the clinical outcomes of two groups were recorded. Results After treatment,the scores of nausea and vomiting,abdominal distension,ascites,jaundice,asthenia,loss of appetite,and less urine in the two groups were decreased significantly（ all P〈0. 05）,and the above scores in the observation group were lower significantly than those in the control group（ all P〈0. 05）; the levels of TBil,AST,ALT,GGT,ALB,PA,Plt and PTA in the two groups were significantly improved（ all P〈0. 05）,and the improvement of the observation group was better significantly than that of the control group（ P〈0. 05）; The MELD score and Child-Pugh improved grading score of the two groups were decreased significantly（ all P〈0. 05）,and the scores of the observation group were lower significantly than those

关 键 词：银杏叶提取物 复方甘草酸苷 HBV感染慢加急性肝功能衰竭 核因子-κB 肿瘤坏死因子-α 脂氧素A4 内毒素 

分 类 号：R575.3[医药卫生—消化系统]