Based On The Regulation Of Endotoxin And Inflammatory Factors,the Prevention And Treatment Of Liuwei Xingshen Granules Was Investigated Clinical Study On Minimal Hepatic Encephalopathy(Phlegm Turbid And Upper Mongolian Syndrome)

Objective:To study the clinical efficacy of Liuwei Xingshen Granule in the prevention and treatment of minimal hepatic encephalopathy(phlegm and stagnation syndrome),and to explore the therapeutic mechanism of this formula in the treatment of minimal hepatic encephalopathy in terms of endotoxin and inflammatory factors.Methods: Clinical observation part: The source of the case was selected from May 2018 to May 2019.60 patients with MHE in the Department of Hepatology,the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine,were divided into a control group and a treatment group according to the random number table method.There were 3patients with MHE who dropped out because they requested to withdraw from the trial or had poor compliance.A total of 57 patients were finally included in the statistics of clinical research data;29 patients in the treatment group and 28 patients in the control group.The lactulose control group was treated with lactulose oral solution,and the Chinese medicine treatment group was given oral treatment with Liuweixingshen granules for 2 weeks.Observe NCT-A,DST,liver function(ALT,TBi L),blood ammonia,serum endotoxin(LPS),tumor necrosisfactor-?(TNF-?),interleukin-18(IL-18)Interleukin-6(IL-6)level,TCM symptom score and the occurrence of adverse reactions.Results:1.Comparison of clinical efficacy: The total effective rate of the treatment group is 90.0%,and the total effective rate of the control group is89.0%.There is no statistically significant difference in the clinical efficacy between the two groups(P> 0.05),indicating that the Chinese medicine group and the lactulose group after treatment quite.2.Comparison of NCT-A and DST scores: After 2 weeks of treatment,the NCT-A time and DST score of the control group and the treatment group were significantly improved compared with before treatment.The two groups were different in NCT-A time and DST score.No statistical significance(P>0.05),that is,the Chinese medicine group and the lactulose group have basically the same effect in improving the PHES score.3.Comparison of TCM syndrome points: After 2 weeks of treatment,the levels of TCM syndrome points of the treatment group and the control group were significantly lower than before treatment,and the treatment group was better than the control group.The difference between the two groups was statistically significant(P <0.05).4.Comparison of main liver function(ALT,TBIL): after 2 weeks of treatment,the liver function(ALT,TBi L)of the treatment group and the control group was significantly improved compared with before treatment(P<0.05),and the liver function of the two groups of patients improved after treatment There was no significant difference(P> 0.05).5.Comparison of blood ammonia,LPS,TNF-?,IL-18,IL-6: After 2weeks of treatment,the blood ammonia,LPS,TNF-?,IL-6 of the treatment group and the control group were significantly improved compared withbefore treatment(P<0.05),after treatment,the improvement in the LPS,TNF-? and IL-6 levels in the treatment group was better than the control group(P<0.05);there was no statistically significant difference in blood ammonia between the two groups after treatment(P> 0.05);after treatment in the two groups The level of IL-18 was slightly improved compared with that before treatment,but there was no statistical significance(P> 0.05),and there was no statistically significant difference in IL-18 levels between the two groups after treatment(P> 0.05).6.Safety comparison: during the treatment of MHE patients in this study,due to the lighter dose of Liuwei Xingshen Granules,no adverse reactions occurred during the study;There were no significant changes in blood,urine,stool,renal function or 12-lead electrocardiogram in all patients during the clinical study.Conclusion:Liuwei Xingshen Granule is effective in treating mild hepatic encephalopathy due to phlegm and stagnation syndrome.It can significantly improve the clinical symptoms and cognitive dysfunction of patients with MHE.Its short-term clinical efficacy is comparable to lactulose,but it is improving TCM syndrome Integrating and reducing the levels of LPS,TNF-? and IL-6,its comprehensive curative effect is better than lactulose.