解毒化瘀颗粒对慢性肝衰竭患者干预后Toll样受体表达变化的临床研究

发布时间：2018-06-19 10:41

本文选题：慢性肝衰竭 + 解毒化瘀颗粒　；参考：《广西中医药大学》2016年硕士论文

【摘要】：目的:本研究旨在观察解毒化瘀颗粒治疗慢性肝衰竭的疗效及Toll样受体中TLR2和TLR4的表达变化。方法:按纳入标准选择慢性肝衰竭的住院患者60例,随机均分为治疗组和对照组,对照组30例和治疗组30例;对照组采用西医常规治疗,治疗组采用解毒化瘀颗粒+西医常规综合治疗;记录各个观察点患者中医临床症状评分、生化(TBil、DBil、ALB、ALT、AST)、凝血功能(PT、PTA)、血浆氨、内毒素、TLR2、TLR4、促炎因子(IL-6、IL-8、TNF-a)以及有效率等关键指标的变化,并将两组结果进行比较。结果:1、治疗后两组患者症状积分较前均下降(P0.05),且治疗组下降幅度更大,两组比较差异有统计学意义(P0.05)。2、治疗后两组的TLR2和TLR4与治疗前相比均较前下降,差异有统计学意义(P0.05)。TLR2和TLR4在治疗组中的血清表达量明显低于对照组(P0.05)。3、治疗后两组促炎因子IL-6、IL-8、TNF-a与治疗前相比均较前下降,差异有统计学意义(P0.05)。在治疗组中IL-6、IL-8、TNF-a的血清表达量明显低于对照组(P0.05)。4、治疗后两组内毒素与治疗前相比均较前下降,差异有统计学意义,(P0.05)。在治疗组中内毒素的下降幅度优于对照组(P0.05)。5、治疗后,治疗组患者的TBil、DBil、ALT、AST下降程度均大于对照组(P0.01或0.05),且ALB的上升幅度明显优于对照组(P0.01)。6、治疗组患者的凝血酶原时间缩短、凝血酶原活动度上升优于单纯西医治疗对照组,具有统计学意义(P0.05);但是中药治疗组与单纯西医对照组血浆氨下降数值无统计学意义(P0.05)。7、治疗组的总有效率为50.0%,对照组总有效率为36.6%,两组相比较差异具有统计学意义(P0.05)。8、两组患者在治疗期间没有出现与用药有关的不良事件。结论:在西医常规治疗的基础上联合解毒化瘀颗粒的中西医结合治疗方案治疗慢性肝衰竭的疗效优于单纯西医常规治疗方案,并且解毒化瘀颗粒可能的疗效机制与干预Toll样受体表达有关。
[Abstract]:Aim: to observe the effect of jiedu Huayu granule on chronic liver failure and the expression of TLR2 and TLR4 in Toll-like receptor. Methods: sixty inpatients with chronic liver failure were randomly divided into treatment group (n = 30) and control group (n = 30), control group (n = 30) and control group (n = 30). The patients in the treatment group were treated with routine western medicine treatment of detoxification and Huayu granule, and the changes of clinical symptom scores of traditional Chinese medicine (TCM), biochemical changes of TBildberg, ALB, PTAP, plasma ammonia, endotoxin TLR2, TLR4, IL-6IL-8TNF-a, and the effective rate were recorded in the treatment group. The results of the two groups were compared. Results the symptom scores of the two groups were decreased after treatment (P 0.05), and the decrease was greater in the treatment group. The difference between the two groups was statistically significant (P 0.05). The TLR2 and TLR4 of the two groups decreased after treatment compared with those before treatment, and the scores of TLR2 and TLR4 in the treatment group were significantly lower than those before the treatment. There was significant difference in the serum expression of P0.05U. TLR2 and TLR4 in the treatment group, which was significantly lower than that in the control group (P 0.05). After treatment, the level of IL-6, IL-8, TNF-a in the two groups was lower than that before treatment, and the difference was statistically significant (P 0.05). The serum level of IL-6, IL-8 and TNF-a in the treatment group was significantly lower than that in the control group (P 0.05N. 4). After treatment, endotoxin in both groups was lower than that before treatment, and the difference was statistically significant. The decrease of endotoxin in the treatment group was better than that in the control group (P 0.05. 5). After treatment, the decrease degree of TBildlb alt AST in the treatment group was higher than that in the control group (P 0.01 or 0.05), and the increase of ALB was significantly higher than that in the control group (P 0.01. 6). The prothrombin time of the treatment group was shorter than that of the control group. The increase of prothrombin activity was better than that of the control group treated with western medicine alone. The total effective rate of the treatment group was 50.05 and the total effective rate of the control group was 36.6. The difference between the two groups was statistically significant. There were no adverse events related to drug use during treatment in both groups. Conclusion: on the basis of routine western medicine treatment combined with jiedu Huayu granule, the therapeutic effect of combination of traditional Chinese and western medicine in the treatment of chronic liver failure is better than that of western medicine alone. The possible therapeutic mechanism of jiedu Huayu granule is related to the intervention of Toll-like receptor expression.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R575.3

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