扶正化瘀胶囊联合核苷类抗病毒药物对HBV感染失代偿期肝硬化患者肝肾功能、血清炎性因子、TLR-4、TGF-β1及谷草转氨酶-血小板比值指数的影响

Effects of Fuzheng Huayu Capsules combined with nucleoside antiviral drugs on liver and kidney function,serum inflammatory factors,TLR-4,TGF-β1 and aspartate aminotransferaseplatelet ratio index in patients with HBV infection and decompensated liver

目的:探讨扶正化瘀胶囊联合核苷类抗病毒药物对HBV感染失代偿期肝硬化患者肝肾功能、血清炎性因子、Toll样受体4(TLR-4)、转化生长因子β1(TGF-β1)及谷草转氨酶-血小板比值指数(APRI)的影响。方法:选取HBV感染失代偿期肝硬化患者144例。随机分为对照组和病例组,每组各72例。对照组给予恩替卡韦口服;病例组予恩替卡韦和扶正化瘀。观察2组患者的肝肾功能、血清炎性因子、TLR-4、TGF-β1及APRI的变化。结果:病例组总有效率高于对照组,差异有统计学意义(P<0.05)。病例组HBV DNA转阴率、HBsAg转阴率、HBeAg转阴率明显高于对照组;治疗后ALT、AST、TBIL、HA、LN、PCⅢ、CIV、门静脉内径、脾静脉内径、脾脏厚度、阻力指数、BUN、Cr、IL-6、IL-8、hs-CRP、TNF-α、TLR-4、TGF-β1、APRI较治疗前降低,ALB和肾血流量较治疗前升高;病例组肝功能指标、肝纤维化指标、肝脾影像学指标、肾脏血流动力学指标、血清炎性因子、TLR-4、TGF-β1、APRI改善程度明显优于对照组,差异均有统计学意义(P<0.05)。结论:扶正化瘀胶囊联合核苷类抗病毒药物对HBV感染失代偿期肝硬化患者临床疗效确切,并能有效抑制HBV复制,改善肝肾功能,减轻炎性因子。

Objective: To investigate the effect of Fuzheng Huayu Capsule combined with nucleoside antiviral drugs on liver and kidney function, serum inflammatory factors, Toll-like receptor 4(TLR-4), transforming growth factor β1(TGF-β1)) And aspartate aminotransferase-platelet ratio index(APRI). Methods:A total of 144 patients with HBV infection and decompensated cirrhosis were selected. All patients were divided into control group and case group by random number table method, with 72 cases in each group. The control group was given conventional liver protection and antiviral therapy;the case group was supplemented with Fuzheng Huayu Capsule on the basis of treatment in the control group. The changes of liver and kidney function, serum inflammatory factors, TLR-4, TGF-β1 and APRI in the two groups were observed. Results:The total effective rate of the case group was 93.06%, higher than 76.32% of the control group(P<0.05). In case group, HBV DNA negative rate, negative rate of hepatitis B virus surface antigen(HBsAg), negative rate of hepatitis B virus e antigen(HBeAg) were significantly higher than the those in control group(76.39% vs 59.72%, 55.56% vs 31.94%, 51.39% vs 29.17%), the difference was statistically significant(P<0.05). Alanine aminotransferase(ALT), aspartate aminotransferase(AST), total bilirubin(TBIL), hyaluronic acid(HA), laminin(LN), type Ⅲ procollagen after treatment(PCⅢ), type IV collagen(CIV), inner diameter of portal vein, inner diameter of splenic vein, spleen thickness, resistance index, urea nitrogen(BUN), creatinine(Cr), interleukin-6(IL-6), interleukin-8(IL-8), high-sensitivity C-reactive protein(hs-CRP), tumor necrosis factor-α(TNF-α), TLR-4, TGF-β1, APRI are lower than before treatment, albumin(ALB) and renal blood The flow rate was higher than before treatment;liver function indicators, liver fibrosis indicators, liver and spleen imaging indicators, renal hemodynamic indicators, serum inflammatory factors, TLR-4 in the case group The improvement of TGF-β1 and APRI.Conclusion: Fuzheng Huayu capsules combined with nucleoside antiviral drugs have a clear clinical effect on patients with HBV infection and decompensated liver cirrhosis, significantly improve the clinical symptoms of patients, improve liver and kidney function, reduce inflammatory factor production, and can effectively inhibit HBV replication. Certain promotion value is worthy of further clinical research.