香砂六君子汤加减联合恩替卡韦对乙肝肝硬化失代偿期患者的疗效及对T细胞亚群的影响  

Effect of Xiangsha Liujunzi Decoction combined with Entecavir on T cell subsets in patients with decompensation period of hepatitis B cirrhosis

作　　者：李勇 任立业 徐鹤[3] 刘静[4] 李宏勇[3] 朱凤林[5] LI Yong;REN Liye;XU He;LIU Jing;LI Hongyong;ZHU Fenglin(Department of Traditional Chinese Medicine,Xingtai Medical College,Xingtai,Hebei,054000,China;Department of Gastroenterology, the Second Affiliated Hospital of Xingtai Medical College;Department of Immunomicrobiology, Xingtai Medical College;Department of Biology, Xingtai Medical College;Department of Immunomicrobiology, Cangzhou Medical College)

机构地区：[1]邢台医学高等专科学校中医系中药教研室,河北邢台054000 [2]邢台医学高等专科学校第二附属医院消化内科 [3]邢台医学高等专科学校免疫微生物教研室 [4]邢台医学高等专科学校生物教研室 [5]沧州医学高等专科学校微免教研室

出　　处：《中国中西医结合消化杂志》2024年第1期35-41,共7页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

摘　　要：目的:探讨香砂六君子汤加减联合恩替卡韦对乙肝肝硬化失代偿期患者的疗效和对成纤维细胞生长因子(fibroblast growth factor,FGF)-9、FGF-21及细胞免疫状态的影响。方法:选取2020年5月—2022年12月接受治疗的120例乙肝肝硬化失代偿期患者为研究对象,应用随机数字表法分为对照组和研究组。对照组采取恩替卡韦治疗,研究组在对照组的基础上加用香砂六君子汤,比较两组患者的疗效和治疗前后T细胞亚群的变化情况。结果:研究组治疗总有效率高于对照组(P>0.05)。治疗后对照组和研究组患者的各中医症状积分比治疗前均明显减少,且研究组减少幅度比对照组更大(P<0.05);治疗后对照组和研究组患者的透明质酸(hyaluronic acid,HA)、层黏蛋白(laminin,LN)、Ⅲ型前胶原(procollagenⅢ,PCⅢ)、Ⅳ型胶原(Ⅳcollagen,Ⅳ-C)水平均较治疗前明显减少,前白蛋白(pre-albumin,PA)、白蛋白(albumin,ALB)、血清胆碱酯酶(cholinesterase,CHE)水平明显增加,且研究组上述指标改善程度优于对照组(P<0.05);治疗后两组患者的血清FGF-9水平明显降低,FGF-21水平明显升高,且研究组改善程度优于对照组(P<0.05);治疗后两组患者的T细胞亚群CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均明显升高,CD8^(+)明显降低,且研究组上述指标变化程度高于对照组(P<0.05)。两组患者治疗过程中均未见严重不良反应,患者可耐受。结论:香砂六君子汤联合恩替卡韦治疗乙肝肝硬化能明显改善患者症状,促进肝功能指标恢复,同时还能显著改善FGF-9、FGF-21水平,延缓疾病进展,提升机体细胞免疫功能,值得临床推广应用。Objective:To investigate the effects of Xiangsha Liujunzi Decoction combined with Entecavir on fibroblast growth factor(FGF)-9,FGF-21 and cellular immunity in patients with decompensation period of hepatitis B cirrhosis.Methods:One hundred and twenty patients with decompensated hepatitis B cirrhosis who received treatment in our hospital from May 2020 to December 2022 were selected for this study.They were divided into control group and study group by random number table method.The control group was treated with Entecavir,and the study group was treated with Xiangsha Liujunzi Decoction on the basis of the control group.The therapeutic effect and T cell subsets before and after treatment were compared.Results:The total effective rate of the study group was higher than that of the control group(P>0.05).After treatment,the scores of Traditional Chinese Medicine symptoms in both the control group and the study group were significantly reduced compared with before treatment,and the reduction in the study group was greater than that in the control group(P<0.05).After treatment,hyaluronic acid(HA),laminin,LN,procollagen Ⅲ(PCⅢ) and Ⅳcollagen(Ⅳ-C) decreased significantly compared with that before treatment,and pre-albumin(PA),albumin(ALB) and serum cholinesterase(CHE) increased significantly.The improvement of these indexes in the study group was higher than those in the control group(P<0.05).After treatment,the serum FGF-9 level was significantly decreased and FGF-21 level was significantly increased,T cell subsets CD3^(+),CD4^(+),CD4^(+)/CD8^(+)were significantly increased in both groups,while CD8^(+)was significantly decreased,and the improvement degree of the study group was better than that of the control group(P<0.05).No serious adverse reactions were observed in the two groups,which were tolerated by the patients.Conclusion:Xiangsha Liujunzi Decoction combined with conventional Entecavir can significantly improve the symptoms of patients with hepatitis B cirrhosis,promote the recovery of liver function indi

关 键 词：乙肝肝硬化失代偿期 香砂六君子汤 恩替卡韦 成纤维细胞生长因子 细胞免疫功能 

分 类 号：R289.1[医药卫生—方剂学]