Clinical study on Xinqingkai Decoction in preventing and treating chronic HBV infection-induced liver cirrhosis complicated with mild hepatic encephalopathy

Bingling LIAO; Junfeng ZHU; Lingtai WANG; Gang ZHAO

doi:10.16305/j.1007-1334.2021.2001101

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Clinical study on Xinqingkai Decoction in preventing and treating chronic HBV infection-induced liver cirrhosis complicated with mild hepatic encephalopathy

更新时间：2022-08-03

- Clinical study on Xinqingkai Decoction in preventing and treating chronic HBV infection-induced liver cirrhosis complicated with mild hepatic encephalopathy
- Shanghai Journal of Traditional Chinese Medicine Vol. 55, Issue 2, Pages: 63-67(2021)
- 作者机构：
  
  1.上海中医药大学附属第七人民医院消化内科（上海　200137）
  2.上海中医药大学附属市中医医院肝病科（上海　200071）
  3.上海中医药大学附属曙光医院肝病科（上海　200021）
- 作者简介：
- 基金信息：
- DOI：10.16305/j.1007-1334.2021.2001101
  CLC：
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Bingling LIAO, Junfeng ZHU, Lingtai WANG, et al. Clinical study on Xinqingkai Decoction in preventing and treating chronic HBV infection-induced liver cirrhosis complicated with mild hepatic encephalopathy. [J]. Shanghai Journal of Traditional Chinese Medicine 55(2):63-67(2021)
DOI：

Bingling LIAO, Junfeng ZHU, Lingtai WANG, et al. Clinical study on Xinqingkai Decoction in preventing and treating chronic HBV infection-induced liver cirrhosis complicated with mild hepatic encephalopathy. [J]. Shanghai Journal of Traditional Chinese Medicine 55(2):63-67(2021) DOI： 10.16305/j.1007-1334.2021.2001101.

摘要

目的,2,观察新清开方防治慢性乙型肝炎后肝硬化合并轻微型肝性脑病（MHE）的临床疗效。,方法,2,将68例慢性乙型肝炎后肝硬化合并MHE患者随机分为防治组和对照组，每组34例。在常规抗病毒、保肝及对症支持治疗的基础上，防治组予新清开方口服，对照组予乳果糖口服溶液口服，两组疗程均为30 d。观察两组临床转归情况，比较神经心理学测试指标（NCT-A、DST）、相关生化指标[肝功能中的丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、白蛋白（A）及血氨、内毒素]、肠道菌群的微生物学定量分析指标等的变化情况。,结果,2,①最终完成试验者共64例，防治组33例，对照组31例。②治疗前后组内比较，两组NCT-A、DST水平差异均有统计学意义，其中NCT-A水平均明显降低，DST水平均明显升高（,P,<,0.05）；组间治疗后比较，NCT-A、DST水平的改善情况，防治组均明显优于对照组（,P,<,0.05）。③治疗前后组内比较，两组ALT、AST、A、血氨、内毒素水平差异均有统计学意义，其中ALT、AST、血氨、内毒素水平明显降低，A水平明显升高（,P,<,0.05）；组间治疗后比较，ALT、AST、A、血氨、内毒素水平的改善情况，防治组均明显优于对照组（,P,<,0.05）。④治疗前后组内比较，两组大肠埃希菌、粪肠球菌、双歧杆菌、乳酸杆菌水平差异均有统计学意义，其中大肠埃希菌水平明显降低，粪肠球菌、双歧杆菌、乳酸杆菌水平明显升高（,P,<,0.05）；组间治疗后比较，防治组大肠埃希菌水平明显低于对照组，双歧杆菌水平明显高于对照组（,P,<,0.05）。⑤疗程结束后，两组均未出现转重为临床型肝性脑病者。两组复常率比较（27.3%与6.5%），防治组明显高于对照组（,P,<,0.05）。,结论,2,新清开方可以更好地提高慢性乙型肝炎后肝硬化合并MHE患者的认知能力，改善其肝功能及血氨、内毒素水平，调节肠道菌群，改善其临床转归情况，对本病有一定的防治作用。

Abstract

Objective,2,To observe the clinical effect of Xinqingkai Decoction on chronic HBV infection-induced liver cirrhosis complicated with mild hepatic encephalopathy (MHE).,Methods,2,Sixty-eight patients with chronic HBV infection-induced liver cirrhosis complicated with MHE were randomly divided into prevention and treatment group (,n,=34) and control group (,n,=34). On the basis of routine treatment of antivirus and liver protection, as well as symptomatic support treatment, the prevention and treatment group was administered with Xinqingkai Decoction orally, while the control group was administered with Lactulose Oral Solution. The course of treatment in both groups was 30 days. The clinical prognosis of the two groups was observed, and the changes of neuropsychological test indexes (NCT-A, DST), related biochemical indexes [alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (A), blood ammonia and endotoxin in liver function] and microbiological quantitative analysis indexes of intestinal microbiota were compared before and after intervention.,Results,2,①A total of 64 cases completed the experiment, 33 cases in the prevention and treatment group and 31 cases in the control group. ②There were significant differences in NCT-A and DST levels before and after treatment within both groups. NCT-A levels reduced significantly and DST levels increased significantly after treatment (,P,<,0.05); After treatment, the improvement of NCT-A and DST levels in the prevention and treatment group was significantly better than that in the control group (,P,<,0.05). ③There were significant differences in levels of ALT, AST, albumin, blood ammonia and endotoxin before and after treatment within two groups. The levels of ALT, AST, blood ammonia and endotoxin decreased significantly and the level of albumin increased significantly (,P,<,0.05); After treatment, the improvement of ALT, AST, albumin, blood ammonia and endotoxin levels in the prevention and treatment group was significantly better than that in the control group (,P,<,0.05). ④The levels of ,Escherichia coli,Enterococcus faecalis,Bifidobacterium, and ,Lactobacillus, were significantly different before and after treatment within the two groups. The levels of ,Escherichia coli, decreased significantly, while the levels of ,Enterococcus faecalis,Bifidobacterium, and ,Lactobacillus, increased significantly (,P,<,0.05). After treatment, the level of ,Escherichia coli, in the prevention and treatment group was significantly lower than that in the control group, and the level of ,Bifidobacterium, was significantly higher than that in the control group (,P,<,0.05). ⑤ After the course of treatment, no case was found turning into clinical hepatic encephalopathy in both groups. The recovery rate of the two groups was 27.3% and 6.5%, respectively, and the recovery rate was significantly higher in the prevention and control group than that in the control group (,P,<,0.05).,Conclusion,2,Xinqingkai Decoction has certain prevention and treatment effects on chronic HBV infection-induced liver cirrhosis complicated with MHE as it can better improve the cognitive ability, liver function, blood ammonia and endotoxin levels, regulate intestinal microbiota and improve the clinical outcome.

关键词

新清开方轻微型肝性脑病慢性乙型肝炎后肝硬化临床转归肠道菌群肝肠循环王灵台

Keywords

Xinqingkai Decoctionmild hepatic encephalopathychronic HBV infection-induced liver cirrhosisclinical prognosisintestinal microbiotahepato-intestinal circulationWang Lingtai

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