护肠清毒微丸结肠靶向给药降低血浆内毒素及TNF-α、IL-6、IL-8临床研究Colon-targeted drug Huchangqingdu pellets reduce TNF-α,IL-6 and IL-8
张向磊;胡冬青;孙欢娜;李勇;
摘要(Abstract):
目的探讨护肠清毒微丸结肠靶向给药降低血浆内毒素及TNF-α、IL-6、IL-8的疗效。方法符合纳入标准的慢乙肝相关肠源性内毒素血症患者180例,按随机双盲双模拟对照分为口服乳果糖组、口服护肠清毒微丸组,每组各90例,观察治疗前后血浆内毒素及TNF-α、IL-6、IL-8变化,并比较2种药物的疗效差别。结果2组血浆内毒素、炎性细胞因子较治疗前均明显下降(P<0.01),且护肠清毒微丸疗效优于乳果糖组(P<0.01)。结论护肠清毒微丸结肠靶向释放给药可有效阻断肠源性内毒素血症的发生,改善机体内环境,从而抑制炎性细胞因子的释放,达到修复肝组织损伤的目的,整体疗效优于乳果糖。
关键词(KeyWords): 护肠解毒微丸;肠源性内毒素血症;乳果糖;利湿解毒;活血化瘀
基金项目(Foundation): 国家中医临床研究基地业务建设科研专项(JDZX2012065);; 山东省科技厅科技攻关课题(2007GG2NS02076)
作者(Author): 张向磊;胡冬青;孙欢娜;李勇;
Email:
DOI: 10.13463/j.cnki.jlzyy.2016.09.008
参考文献(References):
- [1]毛毛,李勇,黄书婷.大黄解毒汤灌肠治疗慢性乙型病毒性肝炎肠源性内毒素血症45例[J].陕西中医,2010,31(5):515-516.
- [2]刘乐洋,孙萍,马传江,等.结肠靶向剂护肠清毒微丸的制备工艺研究[J].中国药房,2012,32(11):995-996.
- [3]史宗明,李勇,黄书婷.李勇治疗慢性肝病经验[J].河南中医,2015,3(4):699-700.
- [4]唐世霞,李勇.李勇教授治疗慢性乙型肝炎[J].吉林中医药,2015,35(12):1205-1208.
- [5]BAUER TM,SCHWACHA H,STEINBRUCKNER B,et al.Small intestinal bacterial overgrowth in human cirrhosis is associated with systemic endotoxemia[J].Am J Gastroenterol,2002,97(9):2364-2370.
- [6]HAN DW.Intestinal endotoxemia as a pathogenetic mechanism in liver failure[J].World J Gastroenterol,2002,8(6):961-965.
- [7]ANNA CHIARA PISCAGLIA,VINCENZO ARENA,STEFANO PASSALACQUA,et al.A Case of Granulocyte-Colony Stimulating Factor/Plasmapheresis-Induced Activation of Granulocyte-Colony Stimulating Factor-Positive Hepatic Progenitors in Acute-on-Chronic Liver Failure[J].Hepatology,2015,62(2):649-652.
- [8]S.GAO,F.-K.Sun,Y.-C.FAN,et al.Aberrant GSTP1 promoter methylation predicts short-term prognosis in acute-onchronic hepatitis B liver failure[J].Alimentary Pharmacology and Therapeutics,Aliment Pharmacol Ther 2015,42:319-329.
- [9]赵国荣,陈研焰,毛娅男,等.肝脾理论与肠源性内毒素血症肝损伤的相关性[J].中西医结合肝病杂志,2016,26(2):91-92.
- [10]李勇,孙欢娜,王磊,等.护肠清毒微丸结肠靶向给药降低血浆内毒素及TNF-α、IL-6、IL-8的临床研究[C].北京:中华中医药学会第十五届内科肝胆病学术会议暨国家中医药管理局专科专病协作组(肝病组、传染病组)会议论文汇编,2015:478-480.
- [11]陶亮.肝硬化与肠源性内毒素血症关系的研究进展[J].中国感染控制杂志,2015,14(2):139-144.
- [12]HUANG ZUXIONG,LIN CHUN,FANG JIANKAI,et al.Acute kidney injury in hepatitis B-related acute-on-chronic liver failure without preexisting liver cirrhosis[J].Hepatol Int,2015(9):416-423.
- [13]LI L,WU Z,MA W,et al.Changes in intestinal microflora in patients with chronic severe hepatitis[J].Chin Med J(Engl),2001,114(8):869-872.
- [14]DEEPAK AMARAPURKAR,MRUDUL V DHAROD,MADHURI CHANDNANI,et al.Acute-on-chronic liver failure:A prospective study to determine the clinical profile,outcome,and factors predicting mortality[J].Indian J Gastroenterol,2015,34(3):216-224.
- [15]SHIV KUMAR SARIN,CHANDAN KUMAR KEDARISETTY,ZAIGHAM ABBAS,et al.Acute-on-chronic liver failure:consensus recommendations of the Asian Pacific Association for the Study of the Liver(APASL)[J].Hepatol Int,2014(8):453-471.
- [16]马羽萍,王裕云,吴超,等.从肝与大肠相通理论谈肠源性内毒素血症的防治思路[J].山西中医,2015,36(11):1510-1511.
- [17]罗佳佳,曹吴冰,高连印,等.重型肝炎肠源性内毒素血症的中医药治法初探[J].继续医学教育,2015,29(12):155-156.
- [18]李勇.病毒性肝炎的中医思维理念与思考[J].世界中医药,2008,3(1):8-9.
- [19]LI Y,WANG L,SU C,et al.Clinical observation on the treatment of chronic severe hepatisis B by retention enema with huchang jiedu decoction[J].Chin J Integr Med,2010,16(4):348-352.