茵陈蒿汤联合抗感染治疗对肝硬化合并感染患者肝功能及细胞因子的影响分析
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摘要
目的分析茵陈蒿汤联合抗感染治疗对肝硬化合并感染患者肝功能及细胞因子的影响。方法选择2016年3月-2017年3月医院收治的167例肝硬化合并感染患者为研究对象,按照随机数表法,将患者分为对照组83例和试验组84例,对照组患者采用保肝联合抗感染治疗,试验组在对照组的基础上加用茵陈蒿汤。分析茵陈蒿汤联合抗感染治疗对肝硬化合并感染患者肝功能及细胞因子的影响。结果 167例肝硬化合并感染患者,以自发性腹膜炎患者居多,占47.30%(79/167),其次为消化道感染占26.35%(44/167);167例患者共分离病原菌199株,革兰阴性菌142株占71.36%,以大肠埃希菌为主;两组患者治疗前肝功能及细胞因子水平比较差异无统计学意义,治疗后,两组患者指标水平较治疗前均有改善,且试验组的改善效果优于对照组(P<0.05)。结论肝硬化合并感染患者临床上在保肝、抗感染的基础上加用茵陈蒿汤,可以更好地调节细胞因子,改善炎症状态,保护肝功能,提高治疗效果,值得临床推荐使用。
OBJECTIVE To observe the effect of Yinchenhao decoction combined with anti-infection treatment on liver function and cytokines of hepatocirrhosis patients complicated with infection.METHODS A total of 167 hepatocirrhosis patients complicated with infection who were treated in the hosptal from Mar 2016 to Mar 2017 were recruited as the study objects and randomly divided into the control group with 83 cases and the epxerimental group with 84 cases.The contorl gorup was given liver protection treatment combined with anti-infection treatment,while the experimental group was given additional Yinchenhao decoction on basis of the treatment of the contorl group.The effect of Yinchenhao decoction combined with anti-infection treatment on liver function and cytokines of the hepatocirrhosis patients complicated with infection was observed.RESULTS Of the 167 hepatocirrhosis patients complicated with infection,47.30%(79/167)had spontaneous peritonitis,and 26.35%(44/167)had gastrointestinal tract infection.Totally 199 strains of pathogens were isolated from the 167 patients,142(71.36%)of which were gram-negative bacteria.Escherichia coli was the predominant species of the gram-negative bacteria.There were no significant differences in the levels of liver function indexes and cytokines between the two groups of patients before the treatment.The levels of the above indexes were improved in the two groups after the treatment and were improved significantly better in the experimental group than in the control group(P <0.05).CONCLUSION Yinchenhao decoction combined with anti-infection treatment and liver protection treatment may regulate the cytokines,improve the status of inflammation,protect the liver function and raise the curative effect,and it is worthy to be promoted in the hospital.
OBJECTIVE To observe the effect of Yinchenhao decoction combined with anti-infection treatment on liver function and cytokines of hepatocirrhosis patients complicated with infection.METHODS A total of 167 hepatocirrhosis patients complicated with infection who were treated in the hosptal from Mar 2016 to Mar 2017 were recruited as the study objects and randomly divided into the control group with 83 cases and the epxerimental group with 84 cases.The contorl gorup was given liver protection treatment combined with anti-infection treatment,while the experimental group was given additional Yinchenhao decoction on basis of the treatment of the contorl group.The effect of Yinchenhao decoction combined with anti-infection treatment on liver function and cytokines of the hepatocirrhosis patients complicated with infection was observed.RESULTS Of the 167 hepatocirrhosis patients complicated with infection,47.30%(79/167)had spontaneous peritonitis,and 26.35%(44/167)had gastrointestinal tract infection.Totally 199 strains of pathogens were isolated from the 167 patients,142(71.36%)of which were gram-negative bacteria.Escherichia coli was the predominant species of the gram-negative bacteria.There were no significant differences in the levels of liver function indexes and cytokines between the two groups of patients before the treatment.The levels of the above indexes were improved in the two groups after the treatment and were improved significantly better in the experimental group than in the control group(P <0.05).CONCLUSION Yinchenhao decoction combined with anti-infection treatment and liver protection treatment may regulate the cytokines,improve the status of inflammation,protect the liver function and raise the curative effect,and it is worthy to be promoted in the hospital.
引文
[1]南月敏,牛学敏.肝硬化合并感染的早期识别与经验性治疗[J].临床肝胆病杂志,2015,31(3):349-353.
[2]王晓东,张赤志.茵陈蒿汤联合己椒苈黄丸加减治疗肝硬变腹水临床研究[J].中医学报,2014,29(9):1373-1374.
[3]Xie Y,Tu B,Zhang X,Investigation on outcomes and bacterial distributions of liver cirrhosis patients with gram-negative bacterial bloodstream infection[J].Oncotarget,2018,9(3):3980-3995.
[4]邱时,孙晖,张爱华,等.茵陈蒿汤的研究现状与展望[J].世界中西医结合杂志,2013,8(6):633-637.
[5]孙明瑜,王磊,慕永平,等.茵陈蒿汤对二甲基亚硝胺与四氯化碳诱导的肝硬化大鼠模型凋亡相关基因影响的比较研究[J].中西医结合学报,2011,9(4):423-434.
[6]张维燕,王晓杰,黄容海,等.肝硬化合并细菌感染患者的临床特点及死亡危险因素分析[J].中国医刊,2016,51(8):86-90.
[7]中华人民共和国卫生部.医院感染诊断标准(试行)[J].中华医学杂志,2001,81(5):314-320.
[8]侯金燕,窦志华.茵陈蒿汤保肝作用研究进展[J].中医药导报,2015,14(4):58-60.
[9]Sun H,Zhang AH,Zou DX,et al.Metabolomics coupled with pattern recognition and pathway analysis on potential biomarkers in liver injury and hepatoprotective effects of yinchenhao[J].Appl Biochem Biotechnol,2014,173(4):857-869.
[10]卢锟.茵陈蒿汤联合饮食控制在肝硬化合并肝源性糖尿病患者的临床疗效探讨[J].中国医药导刊,2014,14(4):675-676.
[11]王飞,李晓鸥,张静,等.肝硬化患者肺部感染相关危险因素研究[J].中华医院感染学杂志,2016,26(4):758-760.
[12]郑颖俊,唐海鸿,贺劲松,等.加味茵陈蒿汤联合熊去氧胆酸治疗原发性胆汁性肝硬化的临床研究[J].中西医结合肝病杂志,2012,22(2):89-91.
[13]Zhou J,Li C,Wang L,et al.Hepatoprotective effects of a Chinese herbal formulation,Yingchen decoction,on olaquindox-induced hepatopancreas injury in Jian carp[J].Fish Physiol Biochem,2015,41(1):153-163.
[14]Zhao H,Shi Y,Dong H,et al.Community-or healthcareassociated bacterial infections increase long-term mortality in patients with acute decompensation of cirrhosis[J].Am JMed Sci,2018,355(2):132-139.
[15]李黎,周安朋.医院不同病区细菌感染的分布及药敏分析[J].转化医学电子杂志,2016,3(2):82-83.
[16]娄万爽,杨天兴.茵陈蒿汤加减联合饮食调整在肝硬化合并肝源性糖尿病治疗中的临床疗效观察[J].海峡药学,2012,24(8):147-148.
[17]Wu L,Zhou PQ,Xie JW,et al.Effects of Yinchenhao decoction on self-regulation of renin-angiotensin system by targeting angiotensin converting enzyme 2in bile duct-ligated rat liver[J].J Huazhong Univ Sci Technolog Med Sci,2015,35(4):519-524.
[18]Jiang SL,Hu XD,Liu P.Immunomodulation and liver protection of Yinchenhao decoction against concanavalin A-induced chronic liver injury in mice[J].J Integr Med,2015,13(4):262-268.
[19]Piotrowski D,Boron-Kaczmarska A.Bacterial infections and hepatic encephalopathy in liver cirrhosis-prophylaxis and treatment[J].Adv Med Sci,2017,62(2):345-356.
[20]马应忠,王万春.基层医院实施感染管理培训的效果探讨[J].保健医学研究与实践,2016,13(4):88-89,96.
[21]梁祎雯,谢敏.肝硬化合并全身炎症反应综合征炎症介质水平变化及其临床意义[J].现代消化及介入诊疗,2016,21(3):397-400.
[22]初展.五苓散、茵陈蒿汤、理中丸合方加减治疗肝硬化失代偿期实录[J].内蒙古中医药,2017,36(15):43.
[23]Huang J,Cheung F,Tan HY,et al.Identification of the active compounds and significant pathways of yinchenhao decoction based on network pharmacology[J].Mol Med Rep,2017,16(4):4583-4592.
[24]刘成,刘平,陶庆,等.茵陈蒿汤干预二甲基亚硝胺大鼠肝硬化效应的方证病理学基础研究[J].中国中西医结合杂志,2010,30(8):845-850.
[2]王晓东,张赤志.茵陈蒿汤联合己椒苈黄丸加减治疗肝硬变腹水临床研究[J].中医学报,2014,29(9):1373-1374.
[3]Xie Y,Tu B,Zhang X,Investigation on outcomes and bacterial distributions of liver cirrhosis patients with gram-negative bacterial bloodstream infection[J].Oncotarget,2018,9(3):3980-3995.
[4]邱时,孙晖,张爱华,等.茵陈蒿汤的研究现状与展望[J].世界中西医结合杂志,2013,8(6):633-637.
[5]孙明瑜,王磊,慕永平,等.茵陈蒿汤对二甲基亚硝胺与四氯化碳诱导的肝硬化大鼠模型凋亡相关基因影响的比较研究[J].中西医结合学报,2011,9(4):423-434.
[6]张维燕,王晓杰,黄容海,等.肝硬化合并细菌感染患者的临床特点及死亡危险因素分析[J].中国医刊,2016,51(8):86-90.
[7]中华人民共和国卫生部.医院感染诊断标准(试行)[J].中华医学杂志,2001,81(5):314-320.
[8]侯金燕,窦志华.茵陈蒿汤保肝作用研究进展[J].中医药导报,2015,14(4):58-60.
[9]Sun H,Zhang AH,Zou DX,et al.Metabolomics coupled with pattern recognition and pathway analysis on potential biomarkers in liver injury and hepatoprotective effects of yinchenhao[J].Appl Biochem Biotechnol,2014,173(4):857-869.
[10]卢锟.茵陈蒿汤联合饮食控制在肝硬化合并肝源性糖尿病患者的临床疗效探讨[J].中国医药导刊,2014,14(4):675-676.
[11]王飞,李晓鸥,张静,等.肝硬化患者肺部感染相关危险因素研究[J].中华医院感染学杂志,2016,26(4):758-760.
[12]郑颖俊,唐海鸿,贺劲松,等.加味茵陈蒿汤联合熊去氧胆酸治疗原发性胆汁性肝硬化的临床研究[J].中西医结合肝病杂志,2012,22(2):89-91.
[13]Zhou J,Li C,Wang L,et al.Hepatoprotective effects of a Chinese herbal formulation,Yingchen decoction,on olaquindox-induced hepatopancreas injury in Jian carp[J].Fish Physiol Biochem,2015,41(1):153-163.
[14]Zhao H,Shi Y,Dong H,et al.Community-or healthcareassociated bacterial infections increase long-term mortality in patients with acute decompensation of cirrhosis[J].Am JMed Sci,2018,355(2):132-139.
[15]李黎,周安朋.医院不同病区细菌感染的分布及药敏分析[J].转化医学电子杂志,2016,3(2):82-83.
[16]娄万爽,杨天兴.茵陈蒿汤加减联合饮食调整在肝硬化合并肝源性糖尿病治疗中的临床疗效观察[J].海峡药学,2012,24(8):147-148.
[17]Wu L,Zhou PQ,Xie JW,et al.Effects of Yinchenhao decoction on self-regulation of renin-angiotensin system by targeting angiotensin converting enzyme 2in bile duct-ligated rat liver[J].J Huazhong Univ Sci Technolog Med Sci,2015,35(4):519-524.
[18]Jiang SL,Hu XD,Liu P.Immunomodulation and liver protection of Yinchenhao decoction against concanavalin A-induced chronic liver injury in mice[J].J Integr Med,2015,13(4):262-268.
[19]Piotrowski D,Boron-Kaczmarska A.Bacterial infections and hepatic encephalopathy in liver cirrhosis-prophylaxis and treatment[J].Adv Med Sci,2017,62(2):345-356.
[20]马应忠,王万春.基层医院实施感染管理培训的效果探讨[J].保健医学研究与实践,2016,13(4):88-89,96.
[21]梁祎雯,谢敏.肝硬化合并全身炎症反应综合征炎症介质水平变化及其临床意义[J].现代消化及介入诊疗,2016,21(3):397-400.
[22]初展.五苓散、茵陈蒿汤、理中丸合方加减治疗肝硬化失代偿期实录[J].内蒙古中医药,2017,36(15):43.
[23]Huang J,Cheung F,Tan HY,et al.Identification of the active compounds and significant pathways of yinchenhao decoction based on network pharmacology[J].Mol Med Rep,2017,16(4):4583-4592.
[24]刘成,刘平,陶庆,等.茵陈蒿汤干预二甲基亚硝胺大鼠肝硬化效应的方证病理学基础研究[J].中国中西医结合杂志,2010,30(8):845-850.