清肠祛浊汤治疗肝硬化肠源性内毒素血症的临床效果及机制探讨  

Clinical effect and mechanism discussion of Qingchang Quzhuo Decoction in treating liver cirrhosis with intestinal endotoxemia

作　　者：牛术仙[1] 方红[1] 杜忠海 韩国华[1] 徐庆会[1] NIU Shu-xian;FANG Hong;DU Zhong-hai(Internal Medicine of Liver and Gallbladder,Weifang Hospital of Traditional Chinese Medicine,Weifang 261041,China)

机构地区：[1]潍坊市中医院肝胆内科,261041 [2]潍坊市中医院肿瘤科,261041

出　　处：《中国实用医药》2023年第4期18-21,共4页China Practical Medicine

基　　金：潍坊市卫生健康委员会中医药科研项目(项目编号:2019年(第二类)第5号)。

摘　　要：目的探讨清肠祛浊汤治疗肝硬化肠源性内毒素血症的效果及潜在机制。方法102例肝硬化肠源性内毒素血症患者,根据随机数字表法分为观察组、对照组1和对照组2,每组34例。三组患者均接受21 d常规临床治疗,对照组2患者加用乳果糖治疗,观察组加用清肠祛浊汤结肠滴注治疗。比较三组患者治疗效果及治疗前后血浆内毒素(ET)、血清炎症因子[白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)]水平。结果观察组患者的治疗总有效率为94.12%,显著高于对照组1的61.76%、对照组2的73.53%,差异具有统计学意义(P<0.05)。治疗后,三组患者血浆内毒素水平均较本组治疗前显著下降,差异具有统计学意义(P<0.05);观察组患者血浆内毒素(0.18±0.06)EU/ml低于对照组1的(0.37±0.09)EU/ml、对照组2的(0.29±0.08)EU/ml,差异具有统计学意义(P<0.05)。治疗后,三组患者血清IL-1β、IL-6和TNF-α水平均较本组治疗前下降,差异具有统计学意义(P<0.05);观察组患者血清IL-1β、IL-6和TNF-α分别为(50.08±15.31)、(79.22±24.76)、(9.89±3.26)pg/ml,显著低于对照组1的(77.80±29.84)、(180.89±50.25)、(24.56±8.76)pg/ml和对照组2的(78.41±25.31)、(147.85±13.80)、(18.79±7.09)pg/ml,差异具有统计学意义(P<0.05)。结论清肠祛浊汤治疗肝硬化肠源性内毒素血症具有明显的临床效果,可以显著降低患者血浆内毒素和血清炎症因子水平,为疾病的治疗提供参考和理论依据。Objective To discuss the effect and mechanism of Qingchang Quzhuo Decoction in treating liver cirrhosis with intestinal endotoxemia.Methods A total of 102 liver cirrhosis patients with intestinal endotoxemia in were divided into observation group,control group 1 and control group 2 according to the random numerical table,with 34 patients in each group.Patients in all three groups received 21 d of conventional clinical treatment,while patients in control group 2 were also treated with lactulose and patients in the observation group were also treated with Qingchang Quzhuo Decoction.The therapeutic effects and levels of plasma endotoxin(ET),serum cytokines[interleukin-1β(IL-1β),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)]before and after treatment were compared among the three groups.Results The total effective rate of observation group was 94.12%,which was significantly higher than 61.76%of control group 1 and 73.53%of control group 2,and the difference was statistically significant(P<0.05).After treatment,the plasma endotoxin level in three groups was significantly decreased compared with that before treatment in this group,and the difference was statistically significant(P<0.05).The plasma endotoxin(0.18±0.06)EU/ml in observation group was lower than(0.37±0.09)EU/ml in control group 1 and(0.29±0.08)EU/ml in control group 2,and the difference was statistically significant(P<0.05).After treatment,the serum IL-1β,IL-6 and TNF-αin three groups were decreased compared with those before treatment in this group,and the difference was statistically significant(P<0.05).The serum IL-1β,IL-6 and TNF-αin the observation group were(50.08±15.31),(79.22±24.76)and(9.89±3.26)pg/ml,which were significantly lower than(77.80±29.84),(180.89±50.25),(24.56±8.76)pg/ml in the control group 1,and(78.41±25.31),(147.85±13.80),(18.79±7.09)pg/ml in control group 2.The differences were statistically significant(P<0.05).Conclusion Qingchang Quzhuo Decoction has obvious clinical effect in treating liver cirrhosis wi

关 键 词：肝硬化 肠源性内毒素血症 清肠祛浊汤 乳果糖 内毒素 炎症因子 

分 类 号：R259[医药卫生—中西医结合]