克癀胶囊联合抗病毒治疗代偿期乙肝肝硬化对外周血单个核细胞中核因子活化B细胞κ轻链增强子/诱导型一氧化氮合成酶表达的影响  

Effect of Kehuang Capsules Combined with Antiviral Therapy on Hepatitis B Virus-related Compensated Liver Cirrhosis and the Effect on the Expression of NF-κB/iNOS in Peripheral Blood Mononuclear Cells

作　　者：谢维宁 李玉权 XIE Wei-ning;LI Yu-quan(Department of Infection,Guangdong Integrated Traditional Chinese and Western Medicine Hospital,Foshan Guangdong 528200;Department of Hematology,Qingyuan People′s Hospital,Qingyuan,Guangdong 511518)

机构地区：[1]广东省中西医结合医院感染科,广东佛山528200 [2]清远市人民医院血液科,广东清远511518

出　　处：《世界中西医结合杂志》2022年第12期2460-2463,2468,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：佛山市医学类科技攻关项目(2014AB000872)。

摘　　要：目的探讨克癀胶囊联合抗病毒治疗代偿期乙肝肝硬化对外周血核因子活化B细胞κ轻链增强子(Nuclear factor kappa-light-chain-enhancer of activated B cells,NF-κB)/诱导型一氧化氮合成酶(Inducible nitric oxide synthase,iNOS)表达的影响。方法选取2019年6月—2021年6月期间在广东省中西医结合医院感染科接受治疗的代偿期乙肝肝硬化患者60例,按照随机数字表法分为对照组和观察组,每组各30例。对照组接受临床代偿期乙肝肝硬化常规抗病毒治疗,观察组在对照组的基础上加入克癀胶囊联合治疗。治疗24周后,观察比较两组患者治疗前后肝脏硬度、乙肝病毒DNA载量、肝功能指标[丙氨酸氨基转移酶(Alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(Aspartate aminotransferase,AST)、总胆红素(Total bilirubin,TBIL)]水平、外周血单个核细胞(Peripheral blood mononuclear cells,PBMC)中NF-κB/iNOS表达水平及不良反应发生情况。结果治疗24周后对照组患者肝脏硬度值较治疗前无明显改变,乙肝病毒DNA载量低于治疗前,差异有统计学意义(P<0.05);观察组患者肝脏硬度值、乙肝病毒DNA载量均低于治疗前,差异有统计学意义(P<0.05);且观察组患者肝脏硬度值、乙肝病毒DNA载量低于对照组,差异有统计学意义(P<0.05)。治疗24周后两组患者ALT、AST、TBIL水平均低于治疗前,差异有统计学意义(P<0.05);且观察组患者ALT、AST、TBIL水平均低于对照组,差异有统计学意义(P<0.05)。治疗24周后两组患者PBMC中NF-κB、iNOS mRNA及蛋白表达水平均低于治疗前,差异有统计学意义(P<0.05);且观察组患者PBMC中NF-κB、iNOS mRNA及蛋白表达水平低于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者不良反应发生情况比较,差异无统计学意义(P>0.05)。结论克癀胶囊联合抗病毒治疗可有效减轻代偿期乙肝肝硬化病情,可能与克癀胶囊抑制NF-κB/iNOS信号通路活性的机制相Objective To investigate the effect of Kehuang Capsules combined with antiviral therapy on the expression of NF-κB/iNOS in peripheral blood mononuclear cells(PBMC)in the treatment of hepatitis B virus(HBV)-related compensated liver cirrhosis.Methods A total of 60 patients with HBV-related compensated liver cirrhosis who were treated in Department of Infection,Guangdong Integrated Traditional Chinese and Western Medicine Hospital from June 2019 to June 2021 were selected and randomized into control group(n=30)and observation group(n=30)with the random number table method.Patients in control group received conventional antiviral therapy for the disease,while patients in observation group were treated with Kehuang Capsules and antiviral therapy.After 24 weeks of treatment,liver stiffness,HBV DNA load,liver function indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL)],and NF-κB/iNOS expression level in PBMC were compared between two groups before and after treatment,and the occurrence of drug-related adverse reactions during treatment was recorded.Results After 24 weeks of treatment,control group showed no significant variation in liver stiffness and low HBV DNA load(P<0.05)compared with those before treatment.In observation group,the liver stiffness and HBV DNA load after treatment were lower than those before treatment(P<0.05)and lower than those in the control group(P<0.05).After 24 weeks of treatment,levels of ALT,AST,and TBIL were lower than those before treatment in both groups(P<0.05),and lower in the observation group than in the control group(P<0.05).After treatment,the mRNA and protein levels of NF-κB and iNOS in PBMC were lower than those before treatment(P<0.05),and lower in observation group than in control group(P<0.05).There was no statistical significance in occurrence of drug-related adverse reactions between two groups during treatment(P>0.05).Conclusion The combination of Kehuang Capsules with antiviral therapy can effectively relieve the HBV-related compe

关 键 词：代偿期乙肝肝硬化 克癀胶囊 抗病毒治疗 肝功能 NF-κB/iNOS 

分 类 号：R657.31[医药卫生—外科学]