柔肝养血汤防治妇科肿瘤患者化疗后乙肝病毒再激活所致肝功能损害的临床观察  

Clinical observation of Rougan Yangxue decoction on prevention and treatment of liver functiondamage caused by hepatitis B virus reactivation after chemotherapy in patients with gynecological tumor

作　　者：杨兰兰 胡晓灵 马胜利[1] YANG Lan-lan;HU Xiao-ling;MA Sheng-li(Obstetrics and Gynecology Clinic of Yongcheng People’s Hospital,Yongcheng,Henan 476600,China)

机构地区：[1]永城市人民医院妇产科门诊,河南永城476600

出　　处：《医药论坛杂志》2022年第11期1-4,9,共5页Journal of Medical Forum

基　　金：“艾滋病和病毒性肝炎等重大传染病防治”科技重大专项“十三五”课题(2018ZX10303502-001)。

摘　　要：目的探讨柔肝养血汤防治妇科肿瘤患者化疗后乙肝病毒(HBV)再激活所致肝功能损害的效果。方法选取2019年12月—2021年12月永城市人民医院收治的妇科恶性肿瘤患者86例,均为慢性HBV携带者,随机分为两组各43例,两组均采用紫杉醇联合顺铂化疗方案,中药组同时服用柔肝养血汤,非中药组不服用中药汤剂。比较两组治疗前后肝功能、HBV-DNA再激活情况以及免疫与炎症指标。结果治疗后中药组总胆红素(34.66±8.97)μmol/L、谷丙转氨酶(52.72±14.82)U/L、谷草转氨酶(39.74±18.44)U/L低于非中药组(43.82±12.47)μmol/L、(75.62±16.25)U/L、(65.62±23.71)U/L,血清白蛋白(42.18±10.92)g/L高于非中药组(31.82±8.97 g/L)(P<0.05),肝功能异常患者比例(20.93%)低于非中药组(48.84%)(P<0.05);治疗后中药组HBV-DNA再激活比例(6.98%)低于非中药组(25.58%)(P<0.05);治疗后中药组CD_(3)^(+)(67.82±2.53)、CD_(4)^(+)(36.61±3.77)、CD_(4)^(+)/CD_(8)^(+)(1.52±0.30)高于非中药组(60.54±2.48)、(32.27±3.18)、(1.23±0.25),CD_(8)^(+)(23.16±1.36)低于非中药组(29.33±1.44)(P<0.05);治疗后中药组IL-6(19.73±9.89)ng/L、IL-8(7.84±4.26)ng/L、TNF-α(24.74±9.26)ng/L低于非中药组(27.36±8.58)ng/L、(13.72±5.53)ng/L、(34.27±10.45)ng/L(P<0.05);治疗后中药组SOD(7.13±2.07)U/mL高于非中药组(6.24±1.84)U/mL,MDA(4.58±1.64)μmol/L低于非中药组(7.15±2.49)μmol/L(P<0.05);中药组正常化疗患者比例(93.02%)高于非中药组(72.09%),延期及终止化疗患者比例(6.98%)低于非中药组(27.91%)(P<0.05)。结论柔肝养血汤能够有效防止妇科肿瘤化疗后HBV再激活,改善肝功能.Objective To investigate the effect of Rougan Yangxue decoction on the prevention and treatment of liver function damage caused by hepatitis B virus(HBV)reactivation in gynecological tumor patients after chemotherapy.Methods Totally 86 chronic HBV carriers with gynecological malignant tumor admitted from Dec.2019 to Dec.2021 and were randomly divided into two groups(43 cases each group).Both groups were treated with paclitaxel combined with cisplatin chemotherapy.The TCM group also took Rougan Yangxue decoction,while the non-TCM group didn’t take any traditional chinese medicine.The liver function,HBV-DNA reactivation,immune,inflammatory indexes of the two groups were compared.Results After treatment,total bilirubin(34.66±8.97)μmol/L,alanine aminotransferase(52.72±14.82)U/L and aspartate aminotransferase(39.74±18.44)U/L in the TCM group were lower than those of the non-TCM group(43.82±12.47)μmol/L,(75.62±16.25)U/L,(65.62±23.71)U/L,and serum albumin(42.18±10.92)g/L was higher than that of the non-TCM group(31.82±8.97)g/L(P<0.05).The proportion of abnormal liver function in the TCM group(20.93%)was lower than that of the non-TCM group(48.84%)(P<0.05).After treatment,the proportion of HBV-DNA reactivation in the TCM group(6.98%)was lower than that of the non-TCM group(25.58%)(P<0.05).After treatment,CD_(3)^(+)(67.82±2.53),CD_(4)^(+)(36.61±3.77),CD_(4)^(+)/CD_(8)^(+)(1.52±0.30)in the TCM group were higher than those of the non-TCM group(60.54±2.48),(32.27±3.18),(1.23±0.25).CD_(8)^(+)(23.16±1.36)was lower than that of the non-TCM group(29.33±1.44)(P<0.05);IL-6(19.73±9.89)ng/L,IL-8(7.84±4.26)ng/L and TNF-α(24.74±9.26)ng/L in the TCM group were lower than those of the non-TCM group(27.36±8.58)ng/L,(13.72±5.53)ng/L,(34.27±10.45)Ng/L(P<0.05);After treatment,SOD(7.13±2.07)U/mL in the TCM group was higher than that of the non-TCM group(6.24±1.84)U/mL,MDA(4.58±1.64)μmol/L was lower than that of the non-TCM group(7.15±2.49)μmol/L(P<0.05).The proportion of normal chemotherapy patients in the TC

关 键 词：柔肝养血汤 妇科 肿瘤 乙肝 肝功能 

分 类 号：R512.2[医药卫生—内科学]