滋水涵木方联合多烯磷脂酰胆碱对慢性乙肝肝硬化患者免疫功能的影响

兰少波; 周蜜; 吴新娟; 邵佳微

doi:10.16766/j.cnki.issn.1674-4152.003716

滋水涵木方联合多烯磷脂酰胆碱对慢性乙肝肝硬化患者免疫功能的影响

doi: 10.16766/j.cnki.issn.1674-4152.003716

绍兴文理学院附属医院感染肝病科，浙江绍兴 312000

基金项目:

浙江省中医药科技计划项目 2022ZA175

详细信息

通讯作者:
邵佳微, E-mail: 13157556088@163.com

中图分类号: R657.31
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- 文章访问数: 18
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- 被引次数: 0
出版历程
- 收稿日期: 2024-04-28
- 网络出版日期: 2024-12-28

Effect of Zishuihanmu prescription combined with polyene phosphatidylcholine on immune function in patients with chronic hepatitis B cirrhosis

Department of Infectious Liver Disease, Affiliated Hospital of Shaoxing University of Arts and Sciences, Shaoxing, Zhejiang 312000, China

摘要

摘要: 目的采用滋水涵木方联合多烯磷脂酰胆碱对慢性乙肝肝硬化患者进行治疗，通过观察患者肝功能、肝纤维化、炎症反应、氧化应激、免疫功能等指标变化，对该治疗方案的临床疗效进行评价。方法选取2021年3月—2024年3月绍兴文理学院附属医院收治的慢性乙肝肝硬化患者100例，采用随机数字表法分为对照组、联合组各50例。对照组使用多烯磷脂酰胆碱治疗，联合组使用滋水涵木方联合多烯磷脂酰胆碱治疗。比较2组中医证候评分，检测2组患者肝功能、肝纤维化指标水平及血清总抗氧化能力(TAOC)、晚期蛋白氧化产物(AOPP)、hs-CRP、TNF-α水平，采用流式细胞仪检测CD4⁺、CD3⁺水平，对比2组患者治疗效果。结果治疗后，联合组中医证候评分低于对照组(P＜0.05)。治疗后，联合组肝功能、肝纤维化指标水平低于对照组(P＜0.05)。治疗后，联合组TAOC、AOPP、hs-CRP、TNF-α水平均低于对照组(P＜0.05)。治疗后，联合组CD4⁺、CD3⁺水平分别为42.63±4.89、68.57±6.87，均高于对照组的39.41±3.75、64.21±6.32(P＜0.05)。联合组患者治疗有效率为94.00%(47/50)，高于对照组的80.00%(40/50, P＜0.05)。结论使用滋水涵木方联合多烯磷脂酰胆碱对慢性乙肝肝硬化患者进行治疗，能够减轻患者中医证候严重程度，改善患者肝功能及肝纤维化状况，减轻患者氧化应激、炎症反应严重程度，改善患者免疫功能，治疗效果显著。
- 慢性乙肝肝硬化 /
- 滋水涵木方 /
- 多烯磷脂酰胆碱 /
- 免疫功能
Abstract: Objective To evaluated the clinical efficacy of Zishuhanmu prescription combined with polyene phosphatidylcholine in treating patients with chronic hepatitis B cirrhosis by observing the changes in liver function, liver fibrosis, inflammatory response, oxidative stress, immune function, and other indicators of patients. Methods A total of 100 patients with chronic hepatitis B cirrhosis, admitted to the Affiliated Hospital of Shaoxing University of Arts and Sciences from March 2021 to March 2024, were selected and divided into a control group and a combination group, with 50 patients in each group by random number table method. The control group was treated with polyene phosphatidylcholine, and the combination group was treated with Zishuihanmu prescription combined with polyene phosphatidylcholine. Traditional chinese medicine (TCM) syndrome scores were compared between the two groups, liver function, liver fibrosis index levels, and serum levels of total antioxidant capacity (TAOC), advanced oxidation protein products (AOPP), hypersensitivity C-reactive protein (hs-CRP) and TNF-α were also compared between the two groups. CD4⁺ and CD3⁺ levels were detected by flow cytometry, and the therapeutic effects of the two groups were compared. Results After treatment, the TCM syndrome score of the combination group was lower than that of the control group (P < 0.05). The indexes of liver function and liver fibrosis in the combination group were lower than those in the control group (P < 0.05). Additionally, the levels of TAOC, AOPP, hs-CRP, and TNF-α in the combination group were lower than those in the control group (P < 0.05). The CD4⁺ and CD3⁺ levels in the combination group were 42.63±4.89 and 68.57±6.87, respectively, which were higher than those in the control group (39.41±3.75 and 64.21±6.32, P < 0.05). The effective treatment rate of the combination group was 94.00%, 47/50, higher than that in the control group (80.00%, 40/50, P < 0.05). Conclusion The combination of Zishuihanmu prescription and polyene phosphatidylcholine in the treatment of chronic hepatitis B cirrhosis patients can reduce severity of TCM syndromes, improve liver function and liver fibrosis, alleviate oxidative stress and inflammatory reaction, and enhance immune function, resulting a notable therapeutic effect.
- Chronic hepatitis B cirrhosis /
- Zishuihanmu prescription /
- Polyene phosphatidylcholine /
- Immunologic function

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表 1 2组慢性乙肝肝硬化患者治疗前后中医证候评分比较(x±s，分)

Table 1. Comparison of TCM syndrome scores of the two groups of patients with chronic hepatitis B cirrhosis before and after treatment(x±s, points)

组别	例数	胁痛不舒		腹胀乏力		面色少华
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	50	4.31±1.22	2.46±0.61^b	4.42±1.34	2.38±0.75^b	4.16±1.41	2.52±0.68^b
联合组	50	4.35±1.19	1.71±0.24^b	4.49±1.28	1.65±0.26^b	4.22±1.34	1.66±0.23^b
统计量		0.166^a	16.234^c	0.267^a	17.268^c	0.218^a	19.652^c
P值		0.869	0.001	0.790	0.001	0.828	0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 2 2组慢性乙肝肝硬化患者治疗前后肝功能指标比较(x±s)

Table 2. Comparison of liver function indexes between the two groups of patients with chronic hepatitis B cirrhosis before and after treatment(x±s)

组别	例数	TBIL(μmol/L)		ALT(U/L)		AST(U/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	50	48.12±4.23	30.35±3.46^b	104.45±10.56	66.34±6.76^b	133.26±13.53	78.53±7.33^b
联合组	50	49.21±4.77	16.65±1.69^b	106.65±10.72	39.54±3.24^b	136.43±13.89	46.88±4.72^b
统计量		1.209^a	46.287^c	1.034^a	51.334^c	1.156^a	52.614^c
P值		0.230	0.001	0.304	0.001	0.250	0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 3 2组慢性乙肝肝硬化患者治疗前后肝纤维化指标水平比较(x±s)

Table 3. Comparison of liver fibrosis indexes between the two groups of patients with chronic hepatitis B cirrhosis before and after treatment(x±s)

组别	例数	LN(ng/mL)		PCⅢ(ng/mL)		Ⅳ-C(μg/mL)		HA(ng/mL)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	50	125.21±12.36	98.54±9.23^b	224.43±22.54	150.12±15.15^b	54.32±5.11	35.25±3.64^b	154.45±15.41	123.42±12.56^b
联合组	50	127.53±12.75	78.43±7.56^b	227.76±23.85	114.54±11.76^b	55.63±5.24	26.32±2.56^b	155.65±15.65	97.64±9.49^b
统计量		0.924^a	23.674^c	0.718^a	29.541^c	1.266^a	31.287^c	0.386^a	30.152^c
P值		0.358	0.001	0.475	0.001	0.209	0.001	0.700	0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 4 2组慢性乙肝肝硬化患者治疗前后氧化应激、炎症反应指标水平比较(x±s)

Table 4. Comparison of levels of oxidative stress and inflammatory reaction indicators in the two groups of patients with chronic hepatitis B cirrhosis before and after treatment(x±s)

组别	例数	TAOC(U/mL)		AOPP(nmol/L)		hs-CRP(mg/L)		TNF-α(ng/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	50	15.32±2.27	11.03±1.88^b	153.29±19.67	109.66±13.78^b	11.87±2.41	7.91±1.65^b	21.05±2.78	14.11±2.21^b
联合组	50	15.16±2.21	8.91±1.53^b	155.06±18.68	91.72±11.25^b	11.52±2.33	5.58±1.19^b	21.42±2.65	9.87±1.65^b
统计量		0.357^a	17.659^c	0.461^a	19.223^c	0.738^a	21.543^c	0.681^a	27.172^c
P值		0.722	0.001	0.646	0.001	0.462	0.001	0.497	0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 5 2组慢性乙肝肝硬化患者治疗前后免疫功能指标比较(x±s)

Table 5. Comparison of immune function indexes between the two groups of patients with chronic hepatitis B cirrhosis before and after treatment(x±s)

组别	例数	CD4⁺		CD3⁺
组别	例数	治疗前	治疗后	治疗前	治疗后
对照组	50	36.32±3.12	39.41±3.75^b	60.42±5.44	64.21±6.32^b
联合组	50	36.35±3.21	42.63±4.89^b	60.21±5.52	68.57±6.87^b
统计量		0.047^a	13.678^c	0.192^a	15.661^c
P值		0.962	0.001	0.848	0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 6 2组慢性乙肝肝硬化患者治疗有效率比较[例(%)]

Table 6. Comparison of therapeutic effectiveness between the two groups of patients with chronic hepatitis B cirrhosis[cases (%)]

组别	例数	显效	有效	无效	总有效
对照组	50	25(50.00)	15(30.00)	10(20.00)	40(80.00)
联合组	50	30(60.00)	17(34.00)	3(6.00)	47(94.00)
注：2组总有效率比较，χ²=24.332，P=0.037。

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