重肝汤剂联合组合型人工肝治疗对HBV相关肝衰竭患者疗效、肝功能、凝血功能、外周血T细胞亚群的影响  

Effects of Zhonggan Decoction combined with combined artificial liver therapy on curative effect, liver function, coagulation function and peripheral blood T cell subsets in patients with hepatitis B virus-related liver failure

作　　者：李静 刘艳丽 于彬 柴梅 李沧友 李瑾 朱亚贞 武文文 付锡林 卢伟 LI Jing;LIU Yan-li;YU Bin(Liver Disease Division,Cangzhou Third Hospital,Cangzhou Hebei 061000,China)

机构地区：[1]沧州市第三医院肝病科,河北沧州061000

出　　处：《临床和实验医学杂志》2022年第21期2285-2289,共5页Journal of Clinical and Experimental Medicine

基　　金：沧州市重点研发计划项目(编号:213106125)。

摘　　要：目的分析重肝汤剂联合组合型人工肝治疗乙型肝炎病毒(HBV)相关肝衰竭的临床疗效及安全性。方法回顾性选取2020年1月至2022年6月期间沧州市第三医院收治的经人工肝治疗的HBV慢加急性/亚急性肝衰竭患者120例,按照治疗方法不同分两组,每组各60例。治疗组:重肝汤剂联合组合型人工肝[即半量血浆置换(LPE)联合双重血浆分子吸附系统(DPMAS)],对照组:单纯血浆置换(PE)治疗。对比两组患者的治疗效果、不良反应发生情况、治疗前后的肝功能、凝血功能及外周血T细胞亚群水平。结果治疗组总有效率为91.67%,明显高于对照组(76.67%),差异有统计学意义(P<0.05)。两组患者治疗后,其前白蛋白、白蛋白水平均明显高于治疗前,丙氨酸氨基转移酶(ALT)、总胆红素、总胆汁酸等水平均明显低于治疗前,且治疗组肝功能指标优于对照组,差异均有统计学意义(P<0.05)。两组治疗前后组间凝血功能指标比较,差异无统计学意义(P>0.05),治疗后,两组凝血功能指标较治疗前有明显改善,差异均有统计学意义(P<0.05)。两组患者治疗后,其CD4^(+)、CD4^(+)/CD8^(+)水平均明显高于治疗前,CD8^(+)明显低于治疗前,且与对照组相比,治疗组患者的CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)均明显优于对照组,差异均有统计学意义(P<0.05)。治疗组不良反应与对照组(8.33%vs.11.67%),差异无统计学意义(P>0.05)。结论重肝汤剂联合组合型人工肝治疗HBV相关肝衰竭的效果较好,可有效改善患者的肝肾功能及血清前白蛋白等其他指标水平,安全性较佳,具有较好的临床应用价值。Objective To analyze the clinical efficacy and safety of Zhonggan Decoction combined with combined artificial liver in the treatment of hepatitis B virus(HBV)related liver failure.Methods From January 2020 to June 2022,120 patients with chronic HBV acute/subacute liver failure treated with artificial liver in Cangzhou Third Hospital were retrospectively selected and divided into two groups according to the treatment method,60 cases in each group.Patients in the treatment group were treated with Zhonggan Decoction combined with combined artificial liver[half volume plasma exchange(LPE)combined with dual plasma molecular adsorption system(DPMAS)],and patients in the control group were given plasma exchange(PE)alone.The therapeutic effect,occurrence of adverse reactions,liver function,coagulation function and peripheral blood T cell subsets before and after treatment were compared between the two groups.Results The total effective rate in treatment group was 91.67%,which was significantly higher than that in control group(76.67%),the difference was statistically significant(P<0.05).After treatment,the levels of prealbumin,albumin in 2 groups were significantly higher than before,the levels of alanine transaminase(ALT),total bilirubin and total bile acids were significantly lower than before,and liver function indexes in treatment group were better than control group,the differences were statistically significant(P<0.05).There was no statistically significant difference in the coagulation function indexes between the two groups before and after treatment(P>0.05),but after treatment,the coagulation function indexes of the two groups were significantly improved compared with before treatment,the differences were statistically significant(P<0.05).After treatment,the levels of CD4^(+)and CD4^(+)/CD8^(+)in 2 groups were significantly higher than before treatment,while CD8^(+)was significantly lower than before treatment.The levels of CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)in treatment group were significantly better than contr

关 键 词：HBV相关肝衰竭 重肝汤剂 组合型人工肝 联合治疗 

分 类 号：R512.62[医药卫生—内科学] R575.3[医药卫生—临床医学]