基于血清IL-17细胞表达比例观察解毒化瘀颗粒对乙型肝炎相关性慢加急性肝衰竭预后干预研究
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摘要
目的:基于血清IL-17细胞比例观察解毒化瘀颗粒对乙型肝炎相关性慢加急性肝衰竭(HBV-ACLF)预后的影响。方法:将60例HBV-ACLF患者随机分为治疗组及对照组各30例。对照组给予西医综合治疗,治疗组在对照组基础上辨证予解毒化瘀颗粒。疗程8周,随访2个月。结果:治疗后,治疗组肝功能、总末期肝病模型评分(MELD)和临床症状均优于对照组(P<0.05);治疗组外周血IL-17细胞计数明显低于对照组(P<0.05);治疗组总有效率82.8%,对照组53.6%。结论:中西医结合治疗的临床疗效优于单一西医治疗。解毒化瘀颗粒可以在一定程度上减少患者外周血IL-17细胞的数量,改善肝脏功能,提高生存率。
Objective :Effect of Jiedu Huayu Granule on the prognosis of HBV-ACLF based on the ratio of serum IL-17 cells. Methods :Sixty patients with HBV-ACLF were randomly divided into treatment group and control group,30 cases each. The control group was given comprehensive treatment of Western medicine,the treatment group was given Jiedu Huayu Granule on the basis of the control group. The course of treatment was 8 weeks and followed up for 2 months. Results :After treatment,the liver function,MELD and clinical symptoms of the treatment group were better than the control group(P<0.05);The number of IL-17 cells in the peripheral blood of the treatment group was significantly lower than the control group(P<0.05);The total effective rate of the treatment group was 82.8%,and the control group was 53.6%. Conclusion :The clinical efficacy of integrated Chinese and Western medicine treatment is better than single Western medicine treatment. Jiedu Huayu Granule can reduce the number of IL-17 cells in peripheral blood of patients to a certain extent,improve liver function and improve survival rate.
Objective :Effect of Jiedu Huayu Granule on the prognosis of HBV-ACLF based on the ratio of serum IL-17 cells. Methods :Sixty patients with HBV-ACLF were randomly divided into treatment group and control group,30 cases each. The control group was given comprehensive treatment of Western medicine,the treatment group was given Jiedu Huayu Granule on the basis of the control group. The course of treatment was 8 weeks and followed up for 2 months. Results :After treatment,the liver function,MELD and clinical symptoms of the treatment group were better than the control group(P<0.05);The number of IL-17 cells in the peripheral blood of the treatment group was significantly lower than the control group(P<0.05);The total effective rate of the treatment group was 82.8%,and the control group was 53.6%. Conclusion :The clinical efficacy of integrated Chinese and Western medicine treatment is better than single Western medicine treatment. Jiedu Huayu Granule can reduce the number of IL-17 cells in peripheral blood of patients to a certain extent,improve liver function and improve survival rate.
引文
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[12]沈敏,林明强,冯奇桃,等. HBV相关慢加亚急性肝衰竭患者中Th17细胞、Treg细胞的变化及其与肝功能和HBV-DNA载量间的研究[J].海南医学,2016,27(5):692-696.
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[16]章林平,孙倩,王威,等.茵陈有效成分的药理作用及其临床应用的研究进展[J].抗感染药学,2014,11(1):28-31.
[17]陆小华,马骁,王建,等.赤芍的化学成分和药理作用研究进展[J].中草药,2015,46(4):595-602.
[18]张慧林,赵妍.大黄的药理作用及临床应用分析[J].光明中医,2015,30(5):1119-1121.
[19]纪宝玉,范崇庆,裴莉昕,等.白花蛇舌草的化学成分及药理作用研究进展[J].中国实验方剂学杂志,2014,20(19):235-240.
[20]王睿,费洪新,李晓明,等.石菖蒲的化学成分及药理作用研究进展[J].中华中医药学刊,2013,31(7):1606-1610.
[21]刘华钢,刘俊英,赖茂祥,等.郁金化学成分及药理作用的研究进展[J].广西中医学院学报,2008,11(2):81-83,86.
[2] Tsang S W,Chan H L,Leung N W,et al. Lamivudine treatment for fulminant hepatic failure due to acute exacerbation of chronic hepatitis B infection[J]. Alimentary Pharmacology&Therapeutics,2001,15(11):1737-1744.
[3] Pedra J H F,Sutterwala F S,Sukumaran B,et al. ASC/PYCARD and caspase-1 regulate the IL-18/IFN-gamma axis during Anaplasma phagocytophilum infection[J]. Journal of Immunology,2007,179(7):4783-4791.
[4]郭江燕,高梓珊,姜姝姝,等. IL-17和NF-κB通路与类风湿性关节炎的相关性研究[J].长春中医药大学学报,2015,31(1):192-194.
[5]吴捷,修文叔,林楠,等.白介素-17在幼年大鼠炎症性肠病中表达及意义[J].临床军医杂志,2016,44(2):156-159.
[6]毛德文.解毒化瘀Ⅱ方[J].广西中医药,2007,30(4):39.
[7]中华医学会感染病学分会肝衰竭与人工肝学组.肝衰竭诊治指南(2012年版)[J].中华肝脏病杂志,2013,21(3):210-216.
[8]毛德文,龙富立,盛庆寿,等.解毒化瘀颗粒治疗慢性重型肝炎内毒素血症的临床研究[J].四川中医,2013,31(6):78-80.
[9]王易.免疫学导论[M].北京:中国中医药出版社,2013:33.
[10] Weaver C T,Hatton R D,Mangan P R,et al. IL-17 family cytokines and the expanding diversity of effector t cell lineages[J].Annual Review of Immunology,2007,25(25):821-852.
[11]龙富立,陈小明,王娜,等.基于IL-17在CD4+T细胞表达比例观察解毒化瘀颗粒对慢加急性肝衰竭预后干预的研究[J].时珍国医国药,2017,28(4):796-798.
[12]沈敏,林明强,冯奇桃,等. HBV相关慢加亚急性肝衰竭患者中Th17细胞、Treg细胞的变化及其与肝功能和HBV-DNA载量间的研究[J].海南医学,2016,27(5):692-696.
[13] Harrington L E,Hatton R D,Mangan P R,et al. Interleukin17-producing CD4+effector T cells develop via a lineage distinct from the T helper type 1 and 2 lineages[J]. Nature Immunology,2005,6(11):1123-1132.
[14] MENG Z,ZHANG Y,WEI Z,et al. High serum resistin associates with intrahepatic inflammation and necrosis:an index of disease severity for patients with chronic HBV infection[J].BMC Gastroenterology,2017,17(1):6.
[15]毛德文,韦艾凌,姚春,等.毒浊理论在慢性重型肝炎中的应用浅析[J].四川中医,2009,27(9):23-25.
[16]章林平,孙倩,王威,等.茵陈有效成分的药理作用及其临床应用的研究进展[J].抗感染药学,2014,11(1):28-31.
[17]陆小华,马骁,王建,等.赤芍的化学成分和药理作用研究进展[J].中草药,2015,46(4):595-602.
[18]张慧林,赵妍.大黄的药理作用及临床应用分析[J].光明中医,2015,30(5):1119-1121.
[19]纪宝玉,范崇庆,裴莉昕,等.白花蛇舌草的化学成分及药理作用研究进展[J].中国实验方剂学杂志,2014,20(19):235-240.
[20]王睿,费洪新,李晓明,等.石菖蒲的化学成分及药理作用研究进展[J].中华中医药学刊,2013,31(7):1606-1610.
[21]刘华钢,刘俊英,赖茂祥,等.郁金化学成分及药理作用的研究进展[J].广西中医学院学报,2008,11(2):81-83,86.