健脾化臌汤联合大黄[庶虫]虫丸对乙型肝炎后肝硬变腹水患者T细胞亚群及血清HA、Alb水平变化的影响

目的:探讨健脾化臌汤联合大黄庶虫]虫丸对乙型肝炎后肝硬变腹水患者T细胞亚群及血清透明质酸(Hyaluronic acid,HA)、白蛋白(Albumin,Alb)水平的影响。方法:选择2014年7月至2016年9月在本院接受治疗的乙型肝炎后肝硬变腹水患者79例,按随机数字表法分为对照组39例和观察组40例。对照组给予大黄庶虫]虫丸口服治疗,观察组在对照组治疗的基础上加用健脾化臌汤治疗,观察比较两组临床疗效及治疗前后T细胞亚群(CD4^+、CD8^+、CD4^+/CD8^+)与血清HA、Alb水平变化情况,并统计两组患者不良反应发生情况及腹水消退时间、生存质量(Quality Of Life,QOL)评分。结果:观察组有效率为92.50%,对照组有效率为74.36%,观察组有效率高于对照组,差异具有统计学意义(P<0.05);观察组治疗后CD4^+及CD4^+/CD8^+均高于对照组,差异具有统计学意义(P<0.05);治疗后,观察组血清HA水平低于对照组,血清Alb水平高于对照组,差异具有统计学意义(P<0.05);观察组不良反应发生率为12.50%,对照组不良反应发生率为10.26%,两组不良反应发生率比较,差异无统计学意义(P>0.05);治疗后,观察组QOL评分高于对照组,且腹水消退时间少于对照组,差异具有统计学意义(P<0.05)。结论:健脾化臌汤联合大黄庶虫]虫丸治疗乙型肝炎后肝硬变腹水,可改善患者血清透明质酸、白蛋白水平及T细胞亚群,提高患者生存质量,且安全性高。

The Influence of Decoction for Invigorating Spleen and Resolving Tympanites in Combination with Dahuang Zhechong Pill on the Changes of T Cell Subsets and Serum HA and ALB Levels in Patients with Cirrhosis Ascites After Hepatitis B

Objective:To investigate influence of Decoction for Invigorating Spleen and Resolving Tympanites in combination with Dahuang Zhechong Pill(DHZCP)on the changes of T cell subsets and serum hyaluronic acid(HA)and albumin(ALB)levels in patients with cirrhosis ascites after hepatitis B.Methods:A total of 79 patients with hepatocirrhosis ascites after hepatitis B treated in our hospital from July 2014 to September 2016 were selected and divided into the control group with 39 cases and the observation group with 40 cases.The control group was treated with DHZCP,while the observation group was treated with Decoction for Invigorating Spleen and Resolving Tympanites on the basis of the control group.Then the clinical effects of the two groups and the changes of T cell subsets(CD4^+,CD8^+,CD4^+/CD8^+)and serum HA,ALB levels before and after the treatment were observed and compared,and the occurrence of adverse reactions,ascites regression time,quality of life(QOL)score of the two groups were counted.Results:The effective rate was 92.50%in the observation group and 74.36% in the control group.The effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).After the treatment,CD4^+ and CD4^+/CD8^+ in the observation group were higher than those in the control group,and all the differences were statistically significant(P<0.05).After the treatment,the serum HA level of the observation group was lower than that of the control group,and the serum ALB level was higher than that of the control group,and all the differences were statistically significant(P<0.05).The incidence of adverse reactions was 12.50% in the observation group and 10.26% in the control group.There was no significant difference between the two groups(P>0.05).After the treatment,QOL score of the observation group was higher than that of the control group,and the time of ascites regression was shorter than that of the control group,and all the differences were statistically significant(P<0.05).Conclusion:Decoction for Invigorating Spleen and Resolving Tympanites in combination with DHZCP has a remarkable efficacy on hepatocirrhosis ascites after hepatitis B,can improve the level of serum hyaluronic acid,albumin and T cell subsets,improve the quality of life of patients,and has high safety.