清热利胆自拟方联合熊去氧胆酸对原发性胆汁性胆管炎患者肝功能、免疫功能及炎症因子的影响  

Effect of self-made Qingre Lidan decoction combined with ursodeoxycholic acid on liver function,immune function and inflammatory factors in patients with primary biliary cholangitis

作　　者：王瑛[1] 袁鹤立 赵利[1] 王文鸽[1] 王清贤[3] 袁楠[1] WANG Ying;YUAN Heli;ZHAO Li;WANG Wenge;WANG Qingxian;YUAN Nan(Kailuan General Hospital(Hebei Hepatobiliary Research Institute of Integrated Traditional Chinese and Western Medicine), Tangshan 063000, Hebei, China;The Affiliated Hospital of North China University of Science and Technology, Tangshan 063000, Hebei, China;Tangshan Hospital of Traditional Chinese Medicine, Tangshan 063000, Hebei, China)

机构地区：[1]开滦总医院(河北省中西医结合肝胆病研究所),河北唐山063000 [2]华北理工大学附属医院,河北唐山063000 [3]唐山市中医医院,河北唐山063000

出　　处：《现代中西医结合杂志》2021年第15期1606-1610,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2020425)。

摘　　要：目的探讨清热利胆自拟方联合熊去氧胆酸对原发性胆汁性胆管炎患者的肝功能、免疫功能及炎症因子的影响。方法选取2016年6月—2019年1月在开滦总医院中西医结合肝胆科门诊及病房诊断为原发性胆汁性胆管炎的91例患者,根据随机抽签法分为2组,对照组49例给予熊去氧胆酸胶囊治疗,观察组42例在对照组治疗基础上给予清热利胆自拟方治疗,2组均治疗3周。检测2组治疗前及治疗10 d、20 d后血清肝功能指标[碱性磷酸酶(ALP)、谷丙转氨酶(ALT)、γ-谷氨酰转肽酶(GGT)、总胆红素(TBil)]、免疫功能指标(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、炎症因子[白细胞介素-1(IL-1)、白细胞介素-2(IL-2)、肿瘤坏死因子-α(TNF-α)]水平;随访1年,比较2组并发症发生情况。结果2组患者治疗10 d、20 d后血清ALP、ALT、GGT、TBil、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、IL-1、IL-2、TNF-α水平均明显低于治疗前(P均<0.05);治疗10 d后,2组上述各指标比较差异均无统计学意义(P均>0.05);治疗20 d后,观察组血清GGT、TBil、CD4^(+)、CD4^(+)/CD8^(+)、IL-2、TNF-α水平均明显低于对照组(P均<0.05),CD8^(+)明显高于对照组(P均<0.05)。随访期间,观察组并发症发生率为9.5%(4/42),对照组为26.5%(13/49),观察组并发症发生率明显低于对照组(P<0.05)。结论清热利胆自拟方联合熊去氧胆酸对原发性胆汁性胆管炎患者的肝功能及免疫功能、炎症因子水平有良好的调节作用,并可以减少并发症发生。Objective It is to investigate the effect of Self-made Qingre Lidan decoction combined with ursodeoxycholic acid on liver function,immune function and inflammatory factors in patients with primary biliary cholangitis.Methods A total of 91 patients diagnosed with primary biliary cholangitis in the outpatient and ward of the Hepatobiliary Department of Integrated Traditional Chinese and Western Medicine of Kailuan General Hospital from June 2016 to January 2019 were divided into 2 groups according to the random drawing method,49 cases in the control group were treated with ursodeoxycholic acid capsules,42 cases in the observation group were treated with self-made Qingre Lidan decoction on the basis of the control group.Both groups were treated for 3 weeks.The levels of serum liver function indexes[alkaline phosphatase(ALP),alanine aminotransferase(ALT),γ-glutamyl transpeptidase(GGT),total bilirubin(TBil)],immune function indicators(CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),inflammatory factors[interleukin-1(IL-1),interleukin-2(IL-2),tumor necrosis factor-α(TNF-α)]were determined before treatment and 10d and 20d after treatment in the two groups;the occurrence of complications in the two groups was compared after follow up for one year.Results The levels of serum ALP,ALT,GGT,TBil,CD4^(+),CD8^(+),CD4^(+)/CD8^(+),IL-1,IL-2,and TNF-αof patients in the two groups were significantly lower after 10 d and 20 d treatment than those before treatment(all P<0.05);after 10 days of treatment,there was no significant difference in the above indicators between the two groups(all P>0.05);after 20 days of treatment,the levels of serum GGT,TBil,CD4^(+),CD4^(+)/CD8^(+),IL-2,and TNF-αin the observation group were significantly lower and CD8^(+)was significantly higher than than those in the control group(all P<0.05).During the follow-up period,the complication rate of the observation group was 9.5%(4/42)and that of the control group was 26.5%(13/49),the complication rate of the observation group was significantly lower than that of the con

关 键 词：清热利胆方 原发性胆汁性胆管炎 免疫因子 炎症因子 

分 类 号：R657.45[医药卫生—外科学]