凉血解毒方干预慢性重型肝炎疗效及内毒素受体通路研究

目的:观察凉血解毒方干预慢性重型肝炎的临床疗效及对内毒素受体通路的干预作用。方法:选取慢性重型肝炎患者58例,随机分为对照组(基础治疗组)30例和观察组(基础治疗+凉血解毒方)28例,疗程2周,共2个疗程。观察治疗前后症状积分、血清学变化、治疗后总有效率,同时观察两组患者的血浆内毒素水平、可溶性CD14 sCD14水平、测定Toll样受体4基因(TLR4 mRNA)水平。结果:观察组总有效率(78.6%)优于对照组(66.7%),差异有统计学意义(P<0.05);两组均可改善临床症状,改善肝功能,升高凝血酶原活动度,观察组与对照组比较,差异有统计学意义(P<0.05);两组慢性重型肝炎治疗前内毒素水平、sCD14水平、TLR4 mRNA水平比较无显著性差异,有可比性,治疗后观察组血浆内毒素水平、sCD14水平、TLR4 mRNA水平较治疗前降低,与对照组比较差异有统计学意义(P<0.05)。结论:凉血解毒方治疗慢性重型肝炎可提高临床疗效,其机制可能与干预慢性重型肝炎患者内毒素受体通路有关。

Therapeutic Effect of Cooling Blood to Remove Toxin Recipe in Treating Severe Chronic Hepatitis and Intervening Effect of LPS Recognition Receptor

Objective: To study the therapeutic effect of Chinese tradition medicine recipe with the function of cooling blood to remove toxin in treating severe chronic hepatitis and intervening effect of lipopolysacch aride(LPS) recognition receptors. Method: Fifty-eight cases with chronic severe hepatitis patients were rando mLy divided into control group with 30 cases (basic treatment) and observation group with 28 cases (basic treatment plus Chinese herb with the function of cooling blood to remove toxin). The clinical symptom score, serological change, the rate of clinical efficiency after treatment were observed after four weeks, and the levels of endtoxin, sCD14, TLR4 mRNA were detected. Result: The rate of clinical efficiency of observation group(78.6%) was superior to the control group(66.7%), there was significantl difference between two groups(P<0.05). The clinical symptoms of two groups were improved to various degrees, liver function was ameliorated, chdinest erase(CHE) increased in observation group and there was a significant difference compared with the control group (P<0.05). There were no difference in the levels of endtoxin, sCD14, TLR4 mRNA before treatment between two groups. The levels of endotoxin, sCD14, TLR4 mRNA decreased in observation group after treatment and there was a difference compared with the control group(P<0.05). Conclusion: Chinese tradition medicine recipe with cooling blood to remove toxin is an effective method in treating chronic severe hepatitis, with a high therapeutic effect, and may intervene LPS recognition receptors.