温阳利湿化瘀方对乙肝相关慢加急性肝衰竭患者早期血清内毒素和炎症因子的影响  

Effect of Wenyang Lishi Huayu Decoction on Early Serum Endotoxin and Inflammatory Factors in Patients with HBV-related Chronic and Acute Liver Failure

作　　者：张修举[1] 郭瑞 张引强[1] 陈艳[1] 宋烨闻 Zhang Xiuju;Guo Rui;Zhang Yinqiang;Chen Yan;Song Yewen(Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 110091,China)

机构地区：[1]中国中医科学院西苑医院,北京100091

出　　处：《中国中医急症》2022年第1期38-41,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(81673967)。

摘　　要：目的探讨温阳利湿化瘀方对乙肝相关慢加急性肝衰竭(HBV-ACLF)患者早期血清内毒素(ET)和炎症因子的影响。方法将146例HBV-ACLF早期患者按照随机数字表法分为观察组与对照组各73例。对照组患者参照指南予以西医常规治疗,观察组在对照组治疗基础上采用温阳利湿化瘀方治疗。比较两组治疗前后的中性粒细胞/淋巴细胞比值(NLR)、血清白细胞介素-6(IL-6)和ET水平,观察两组肝功能指标、中医证候评分、MELD评分和凝血功能的差异性,比较两组中医证候疗效。结果观察组治疗后NLR、IL-6、ET水平显著低于对照组(P<0.05)。观察组治疗后肝功能指标和凝血功能指标较对照组显著改善(P<0.05)。观察组治疗后1周、2周、3周的中医证候评分和MELD评分显著低于对照组(P<0.05)。观察组中医证候总有效率为86.30%,明显高于对照组的65.75%(P<0.05)。结论在西医治疗基础上联合温阳利湿化瘀方治疗HBV-ACLF患者可显著改善其肝功能和凝血功能指标,疗效良好,有助于患者病情严重程度和中医证候评分,可能与降低血清内毒素和炎症因子水平有关。Objective:To investigate the effect of Wenyang Lishi Huayu Decoction on serum endotoxin(ET)and inflammatory factors in patients with hepatitis B-related acute-on-chronic liver failure(HBV-ACLF).Methods:A total of 146 patients with early HBV-ACLF were randomly divided into the observation group and control group,73 cases in each group.Patients in the control group were treated with routine western medicine according to the guidelines,while patients in the observation group were treated with Wenyang Lishi Huayu Decoction on the basis of the control group.The neutrophil/lymphocyte ratio(NLR),serum interleukin-6(IL-6)and ET levels before and after treatment were compared between the two groups.The differences of liver function indexes,TCM syndrome score,MELD score and coagulation function between the two groups were observed,and the curative effect of TCM syndrome was compared between the two groups.Results:The levels of NLR,IL-6 and ET in the observation group after treatment were significantly lower than those in the control group(P<0.05).After treatment,the liver function index and coagulation function index in the observation group were significantly improved compared with those in the control group(P<0.05).The TCM syndrome score and MELD score of the observation group at 1 week,2 weeks and 3 weeks after treatment were significantly lower than those of the control group(P<0.05).The total effective rate of TCM syndrome in the observation group was 86.30%,which was significantly higher than65.75%in the control group(P<0.05).Conclusion:On the basis of Western medicine treatment,Wenyang Lishi Huayu Decoction in the treatment of HBV-ACLF patients can significantly improve their liver function and coagulation function indexes,and the curative effect is good,which is helpful for the severity of the disease and the TCM syndrome score,and its mechanism may be related to the reduction of serum endotoxin and inflammatory factors.

关 键 词：乙肝相关慢加急性肝衰竭 温阳利湿化瘀方 内毒素 炎症因子 

分 类 号：R575.3[医药卫生—消化系统]