本文選題：慢性肝衰竭 + 解毒化瘀顆粒�。� 參考：《廣西中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:本研究旨在觀察解毒化瘀顆粒治療慢性肝衰竭的療效及Toll樣受體中TLR2和TLR4的表達(dá)變化。方法:按納入標(biāo)準(zhǔn)選擇慢性肝衰竭的住院患者60例,隨機(jī)均分為治療組和對(duì)照組,對(duì)照組30例和治療組30例;對(duì)照組采用西醫(yī)常規(guī)治療,治療組采用解毒化瘀顆粒+西醫(yī)常規(guī)綜合治療;記錄各個(gè)觀察點(diǎn)患者中醫(yī)臨床癥狀評(píng)分、生化(TBil、DBil、ALB、ALT、AST)、凝血功能(PT、PTA)、血漿氨、內(nèi)毒素、TLR2、TLR4、促炎因子(IL-6、IL-8、TNF-a)以及有效率等關(guān)鍵指標(biāo)的變化,并將兩組結(jié)果進(jìn)行比較。結(jié)果:1、治療后兩組患者癥狀積分較前均下降(P0.05),且治療組下降幅度更大,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2、治療后兩組的TLR2和TLR4與治療前相比均較前下降,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。TLR2和TLR4在治療組中的血清表達(dá)量明顯低于對(duì)照組(P0.05)。3、治療后兩組促炎因子IL-6、IL-8、TNF-a與治療前相比均較前下降,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。在治療組中IL-6、IL-8、TNF-a的血清表達(dá)量明顯低于對(duì)照組(P0.05)。4、治療后兩組內(nèi)毒素與治療前相比均較前下降,差異有統(tǒng)計(jì)學(xué)意義,(P0.05)。在治療組中內(nèi)毒素的下降幅度優(yōu)于對(duì)照組(P0.05)。5、治療后,治療組患者的TBil、DBil、ALT、AST下降程度均大于對(duì)照組(P0.01或0.05),且ALB的上升幅度明顯優(yōu)于對(duì)照組(P0.01)。6、治療組患者的凝血酶原時(shí)間縮短、凝血酶原活動(dòng)度上升優(yōu)于單純西醫(yī)治療對(duì)照組,具有統(tǒng)計(jì)學(xué)意義(P0.05);但是中藥治療組與單純西醫(yī)對(duì)照組血漿氨下降數(shù)值無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。7、治療組的總有效率為50.0%,對(duì)照組總有效率為36.6%,兩組相比較差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。8、兩組患者在治療期間沒(méi)有出現(xiàn)與用藥有關(guān)的不良事件。結(jié)論:在西醫(yī)常規(guī)治療的基礎(chǔ)上聯(lián)合解毒化瘀顆粒的中西醫(yī)結(jié)合治療方案治療慢性肝衰竭的療效優(yōu)于單純西醫(yī)常規(guī)治療方案,并且解毒化瘀顆�？赡艿寞熜C(jī)制與干預(yù)Toll樣受體表達(dá)有關(guān)。
[Abstract]:Aim: to observe the effect of jiedu Huayu granule on chronic liver failure and the expression of TLR2 and TLR4 in Toll-like receptor. Methods: sixty inpatients with chronic liver failure were randomly divided into treatment group (n = 30) and control group (n = 30), control group (n = 30) and control group (n = 30). The patients in the treatment group were treated with routine western medicine treatment of detoxification and Huayu granule, and the changes of clinical symptom scores of traditional Chinese medicine (TCM), biochemical changes of TBildberg, ALB, PTAP, plasma ammonia, endotoxin TLR2, TLR4, IL-6IL-8TNF-a, and the effective rate were recorded in the treatment group. The results of the two groups were compared. Results the symptom scores of the two groups were decreased after treatment (P 0.05), and the decrease was greater in the treatment group. The difference between the two groups was statistically significant (P 0.05). The TLR2 and TLR4 of the two groups decreased after treatment compared with those before treatment, and the scores of TLR2 and TLR4 in the treatment group were significantly lower than those before the treatment. There was significant difference in the serum expression of P0.05U. TLR2 and TLR4 in the treatment group, which was significantly lower than that in the control group (P 0.05). After treatment, the level of IL-6, IL-8, TNF-a in the two groups was lower than that before treatment, and the difference was statistically significant (P 0.05). The serum level of IL-6, IL-8 and TNF-a in the treatment group was significantly lower than that in the control group (P 0.05N. 4). After treatment, endotoxin in both groups was lower than that before treatment, and the difference was statistically significant. The decrease of endotoxin in the treatment group was better than that in the control group (P 0.05. 5). After treatment, the decrease degree of TBildlb alt AST in the treatment group was higher than that in the control group (P 0.01 or 0.05), and the increase of ALB was significantly higher than that in the control group (P 0.01. 6). The prothrombin time of the treatment group was shorter than that of the control group. The increase of prothrombin activity was better than that of the control group treated with western medicine alone. The total effective rate of the treatment group was 50.05 and the total effective rate of the control group was 36.6. The difference between the two groups was statistically significant. There were no adverse events related to drug use during treatment in both groups. Conclusion: on the basis of routine western medicine treatment combined with jiedu Huayu granule, the therapeutic effect of combination of traditional Chinese and western medicine in the treatment of chronic liver failure is better than that of western medicine alone. The possible therapeutic mechanism of jiedu Huayu granule is related to the intervention of Toll-like receptor expression.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R575.3

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