中西医结合对慢性乙型病毒性肝炎高胆红素血症患者肝功能及免疫功能的影响  

Influence of Integrative Medicine on Liver Function and Immunologic Function in Chronic Viral Hepatitis B Patients with Hyperbilirubinemia

作　　者：高慧 GAO Hui(Department of Hepatology,Yulin City TCM Hospital,Yulin 719000,China)

机构地区：[1]榆林市中医医院肝胆科,陕西榆林719000

出　　处：《西部中医药》2020年第2期99-103,共5页Western Journal of Traditional Chinese Medicine

摘　　要：目的:探讨中药退黄合剂直肠滴入与内科综合疗法联合应用对慢性乙型病毒性肝炎(chronic viral hepatitis B)高胆红素血症患者肝功能及免疫功能的影响。方法:用随机抽签法将96例CHB高胆红素血症患者分为两组,每组48例,对照组仅接受内科综合治疗,观察组在实施内科综合治疗基础上,给予退黄合剂直肠滴入治疗。观察两组治疗前后免疫功能(CD4^+、CD8^+、CD3^+、补体C3、免疫球蛋白G(immunoglobulin G,Ig G)、免疫球蛋白M(immunoglobulin M,IgM)、免疫球蛋白A(immunoglobulin A,IgA)、肝功能谷丙转氨酶(glutamic-pyruvic transaminase,ALT)、谷草转氨酶(glutamic-oxalacetic transaminase,AST)、透明质酸(hyaluronic acid,HA)、Ⅳ型胶原(type Iv collagen,IV-C)、血清血红素(TBI、DBL)含量及PTa变化情况;对比2组治疗后临床效果。结果:治疗后,两组患者血清中T淋巴细胞亚群CD4^+、CD3^+、Ig G及IgM含量明显升高(P<0.05),CD8^+含量及补体C3表达水平降低(P<0.05),CD4^+/CD8^+值增大(P<0.05),且观察组CD4^+、CD3^+、Ig G及IgM含量及CD4^+/CD8^+值均高于对照组(P<0.05),CD8^+含量及补体C3表达水平低于对照组(P<0.05);两组患者肝功能指标ALT、AST、HA、IV-C及血清总胆红素(total bilirubin,TBIL)、直接胆红素(direct bilirubin,DBL)含量下降(P<0.05),且PTa明显增大(P<0.05),观察组各指标水平明显优于对照组(P<0.05)。观察组临床总有效率91.67%(43/48),对照组70.83%(34/48),两组比较差异有统计学意义(P<0.05)。结论:退黄合剂直肠滴入法联合内科综合疗法,可显著提高CHB高胆红素血症患者免疫功能,抑制肝脏组织纤维化,改善肝脏功能,降低胆红素含量,提高临床治疗效果。Objective: To discuss the effects of rectum dripping of Tuihuang mixture joined with comprehensive therapy of internal medicine on liver function and immunologic function of chronic viral hepatitis B(CHB) patients with hyperbilirubinemia. Methods: All 96 patients were randomized into two groups using random sampling method,48 cases each group, the control group accepted comprehensive therapy of internal medicine, and the observation group rectum dripping of Tuihuang mixture based on comprehensive therapy of internal medicine. To observe the changes of PTa, the contents of serum heme(TBI and DBL), liver function(ALT, AST, HA and Ⅳ-C) and immunologic function(CD4^+, CD8^+, CD3^+, complements C3, Ig G, Ig M and Ig A) before and after treating in both groups;to compare clinical effects after treating between both groups. Results: After treating, the contents of T lymphocyte subsets CD4^+, CD3^+, Ig G and Ig M in both groups rose notably(P<0.05), the contents of CD8^+and the expressions of complement C3 reduced(P<0.05), CD4^+/CD8^+increased(P<0.05), and the observation group was higher than the control group in the contents of CD4^+, CD3^+, Ig G and Ig M, CD4^+/CD8^+(P<0.05), lower than the control group in the contents of CD8^+and the expressions of complement C3(P<0.05);liver function indexes ALT, AST, HA and IV-C and the contents of TBIL and DBL in both groups lowered(P<0.05), and PTa rose notably(P<0.05), the observation group was superior to the control group in the levels of all the indexes apparently(P<0.05). Clinical total effective rate of the observation group was 91.67%(43/48), higher than 70.83%(34/48) of the control group,and the difference had statistical meaning(P<0.05). Conclusion: The combination of rectum dripping of Tuihuang mixture and comprehensive therapy of internal medicine could notably lift immunologic function of CHB patients,inhibit hepatic fibrosis, improve liver function, reduce the contents of bilirubin and raise clinical therapeutic effects.

关 键 词：肝炎 乙型 高胆红素血症 中西医结合 退黄合剂 直肠滴入 肝功能 免疫功能 

分 类 号：R512.6[医药卫生—内科学]