结肠灌洗联合中药结肠透析治疗慢性重型肝炎对患者血清内毒素与肿瘤坏死因子α等的影响

Effects of Colon Dialysis with the Traditional Chinese Medicine on Endotoxin、TNF-α、IL-6 and IL-2 in Patients with Severe Chronic Hepatitis

目的观察中药结肠透析疗法对慢性重型肝炎患者血清内毒素(ET)、肿瘤坏死因子α(TNF-α)、白细胞介素2(IL-2)、白细胞介素6(IL-6)水平的影响,探讨中药结肠透析疗法在重型肝炎治疗中的意义。方法将60例慢性重型肝炎患者随机分为治疗组和对照组各30例,对照组给予常规护肝支持治疗,治疗组在支持治疗的基础上加用中药结肠透析治疗,4周为1个疗程。观察患者的临床症状改善情况,同时检测治疗前后肝功能等指标,并对治疗前后血清ET、TNF-α、IL-2、IL-6等细胞因子水平进行检测。结果治疗后治疗组肝功能、PT等指标均较对照组改善明显(均P<0.01)。治疗组ET、TNF-α、IL-6水平较对照组下降(均P<0.05)。两组IL-2水平差异无显著性。结论中药结肠透析结合支持疗法治疗慢性重型肝炎能显著改善患者的肝功能,并且对ET、TNF-α、IL-6等炎性细胞因子均有不同程度的清除作用,对IL-2的水平无明显影响。

Objective To investigate effects of colon dialysis with the traditional Chinese medicine on endotoxin, tumor necrosis factor-α, interleukin-6 and interleukin-2 in patients with severe chronic hepatitis. Methods 60 patients with severe chronic hepatitis were randomly divided into the treatment group and control group. The controls were received conventional treatment of hepatoprotection, and the treatments were given conventional treatment and colon dialysis with the traditional Chinese medicine. The symptoms and physical signs of patients were observed, the liver function and changes of blood endotoxin and cytokines （tumor necrosis factor-α,interleukin-6, interleukin-2） were measured before and after 4 weeks of treatment. Results The liver function and prothromhin time were significantly improved in the treatment group than those in the control group（ P 〈 0.01 ）. The levels of endotoxin, tumor necrosis factor-α and interleukin-6 were significantly lowered in the treatment group（ P 〈 0.01 ）. No significant difference of IL-2 was found between two groups. Conclusion The colon dialysis with the traditional Chinese medicine could improve the liver function of patients with chronic severe hepatitis. It removes endotoxin, tumor necrosis factor-α and interleukin-6, but doesnt change the level of interleukin-2.