Clinical Observation On HBV-ACLF Treated By Jianpi Qinghua Decoction And Its Effect On Serum LPS?TNF-??IL-6

Objective : To observe the clinical effects of Jianpi Qinghua Decoction combined with Western comprehensive treatment regimen in the treatment of the early hepatitis B virus acute on chronic liver failure and its effect on serum LPS,TNF-?,and IL-6,and to explore the mechanism of its efficacy.Methods:A total of 46 patients with spleen-deficiency heat-type HBV-ACLF that met the inclusion criteria were selected and divided into treatment group and control group with 23 cases each by randomized control grouping.The control group was given comprehensive western medicine treatment,mainlysa including supportive therapy,antiviral therapy,liver protection treatment,prevention of complications and artificial liver,etc.The treatment group was treated with Jianpi Qinghua Decoction on the basis of the control group.The course of treatment for both groups was 4 week.Before and after treatment,liver function,coagulation function,LPS,TNF-?,IL-6,symptom scores,and safety indicators were all measured.After the end of the statistical analysis of all indicators,P <0.05 said that the difference was statistically significant.Results:1.Comparison of comprehensive curative effects: The treatment group was 22 cases(one case was shed),11 cases were markedly effective,8 cases were effective,2 cases were ineffective,1 case was dead,the total effective rate was 86.36%;21 cases in the control group(falling in 2 cases),6 cases were markedly effective,5 cases were effective,8 cases were invalid and 2 cases were dead,the total effective rate was 52.38%.There was a statistically significant difference between the two groups(P<0.05);2.Comparison of syndromes:After treatment,the scores of symptoms signs in the two groups were significantly lower than those before treatment.The treatment group decreased more significantly than the control group.Statistical analysis showed that the difference was statistically significant(P<0.05);3.Comparison of blood biochemical indexes:After treatment,the decrease of TBIL,ALT and AST in the treatment group was greater than that in the control group,and the increase in PTA was better than that in the control group.Statistical analysis showed that the difference was statistically significant(P<0.05);4.Comparison of laboratory indicators: After treatment,the levels of LPS,TNF-?,and IL-6 in the two groups decreased compared with those before treatment(P<0.05).The decrease was more significant in the treatment group and the difference between the two groups was statistically significant(P< 0.05);5.Safety evaluation: No special abnormalities were found in the renal function,urine routine,stool routine,electrocardiogram,and other safety indicators before and after treatment in the two groups.No significant adverse reactions occurred during the study period.Conclusion:1.The combined treatment of Jianpi Qinghua Decoction and Western medicine can effectively improve the liver function,coagulation function and clinical symptoms of the patients of early hepatitis B virus acute on chronic liver failure,and the overall curative effect is significantly better than that of Western medicine comprehensive treatment plan.2.The therapeutic mechanism of Jianpi Qinghua Decoction in the treatment of HBV-ACLF is related to its ability to eliminate LPS,down-regulate the levels of TNF-? and IL-6,and improve endotoxemia.