苦黄注射液联合多烯磷脂酰胆碱对慢性乙型肝炎合并肝内胆汁淤积症患者血清炎症因子、HO-1、Nrf2水平的影响  

Curative effect of Kuhuang injection combined with polyene phosphatidylcholine in the treatment of chronic hepatitis B complicated with intrahepatic cholestasis and its influence on serum inflammatory factors,HO-1,Nrf2 levels

作　　者：李小珍[1] 冯丹丹[2] 张向超 LI Xiao-zhen;FENG Dan-dan;ZHANG Xiang-chao(The First Affiliated Hospital of Henan University of Science and Technology Gastroenterology Department(Luoyang Henan,471000),China.;不详)

机构地区：[1]河南科技大学第一附属医院消化内科,河南洛阳471000 [2]河南科技大学第一附属医院中心实验室 [3]河南科技大学第一附属医院开元院区急诊科

出　　处：《中西医结合肝病杂志》2024年第12期1078-1082,共5页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

摘　　要：目的:探讨苦黄注射液联合多烯磷脂酰胆碱治疗慢性乙型肝炎(CHB)合并肝内胆汁淤积症(IHC)的疗效,以及对患者血清炎症因子、血红素加氧酶-1(HO-1)、核因子E2相关因子2(Nrf2)水平的影响。方法:选取2022年2月至2023年6月收治的78例CHB合并IHC患者,按随机数字表法分为观察组(n=39)与对照组(n=39)。对照组患者静脉滴注多烯磷脂酰胆碱注射液,观察组患者在对照组患者治疗基础上静脉滴注苦黄注射液治疗,疗程4周。观察两组患者临床疗效及血清炎症因子、HO-1、Nrf2水平。结果:观察组患者总有效率87.18%,高于对照组患者的66.67%(P<0.05)。治疗后,两组患者血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(GGT)等肝脏生化指标水平、瘙痒评分、12项健康调查简表(SF-12)评分、肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-1β、IL-18水平降低(P<0.05),且观察组患者比对照组低(P<0.05)。观察组患者黄疸消退时间短于对照组(P<0.05)。治疗后,血清HO-1、Nrf2水平升高,且观察组患者比对照组高(P<0.05)。观察组患者不良反应发生率为10.26%,与对照组患者的7.69%差异无统计学意义(P>0.05)。结论:苦黄注射液联合多烯磷脂酰胆碱治疗CHB合并IHC疗效及安全性更佳,能有效改善肝功能,促进胆汁淤积症状缓解及提高生活质量,其作用可能与调节患者体内炎症因子和HO-1、Nrf2表达有关。Objective:This study examines the efficacy of Kushuang injection combined with polyene phosphatidylcholine in treating chronic hepatitis B(CHB)complicated by intrahepatic cholestasis(IHC)and evaluates its impact on serum inflammatory cytokines,heme oxygenase-1(HO-1),and nuclear factor E2-related factor 2(Nrf2)levels in patients.Methods:Seventy-eight patients with CHB complicated with IHC admitted to our hospital from February 2022 to June 2023 were selected and divided into observation group(n=39 cases)and control group(n=39 cases)according to random number table method.The control group was treated with polyene phosphatidylcholine injection intravenously,and the observation group was treated with Kuhuang injection intravenously for 4 weeks.The clinical efficacy and serum levels of inflammatory factors,HO-1 and Nrf2 were observed in the two groups.Results:The total effective rate was 87.18%higher than that of control group 66.67%(P<0.05).After treatment,Serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),gamma-glutamyl transpeptidase(GGT)and other liver biochemical indices,itch score,12 health survey summary table(SF-12)score,tumor necrosis factor-α(TNF-α),interleukin(IL)-1βand IL-18 levels in 2 groups were decreased(P<0.05).And the observation group was lower than the control group(P<0.05).The time of jaundice resolution in observation group was shorter than that in control group(P<0.05).The serum HO-1 and Nrf2 levels were increased,and the observation group was higher than the control group(P<0.05).The adverse reaction rate in the observation group was 10.26%compared with 7.69%in the control group(P>0.05).Conclusion:Kuhuang Injection combined with polyene phosphatidylcholine has better efficacy and safety in the treatment of CHB combined with IHC,effectively improving liver function,alleviating cholestasis symptoms and improving quality of life,which may be related to the further regulation of inflammatory factors and the expression of HO-1 and Nrf2 in vivo.

关 键 词：多烯磷脂酰胆碱 苦黄注射液 慢性乙型肝炎 肝内胆汁淤积症 炎症因子 血红素加氧酶-1 核因子E2相关因子2 

分 类 号：R575.6[医药卫生—消化系统]