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中药联合西药治疗乙型肝炎肝硬化的临床疗效及对血清 miR-122、miR-200a 的影响

Clinical effects of combined treatment of traditional Chinese medicine and western medicine for viral hepatitis B cirrhosis and the effects on serum miR-122, miR-200a.

机构信息

Department of Clinical Laboratory, Yantaishan Hospital, Yantai, China.

Department of Hepatology, Yantai Qishan Hospital, Yantai, China.

出版信息

Biotechnol Genet Eng Rev. 2024 Nov;40(3):2803-2817. doi: 10.1080/02648725.2023.2202531. Epub 2023 Apr 14.

Abstract

The aim is to explore the clinical effects of combined treatment of Traditional Chinese Medicine (TCM) and western medicine in viral hepatitis B cirrhosis and the effects on microRNA (miR)-122 and miR-200a. 116 patients with chronic hepatitis B cirrhosis were admitted to our hospital. Real-time fluorescent quantitative PCR (qPCR) was employed to reveal the level of serum miR-122 and miR-200a in the three groups. The clinical effects of the two groups were compared, including alanine aminotransferase (ALT), aspartate amino transferase (AST), total bilirubin (TBIL) and alpha fetoprotein (AFP) indexes, coagulation function indexes, liver elasticity value and the main therapeutic effects. After treatment, the ALT, AST, TBIL and AFP indexes significantly decreased in both groups, which were much lower in the western medicine (WM) + TCM Group. The levels of albumin (ALB) all increased, and the increase was more significant in the WM + TCM Group. The prothrombin time (PT) was down-regulated while the prothrombin activity (PTA) was up-regulated in both groups. Both groups showed a decrease in liver elasticity after treatment, which was more obvious in the WM + TCM Group. The incidence of primary peritonitis, hepatic encephalopathy, hepatorenal syndrome, gastrointestinal bleeding and electrolyte disturbance in the WM + TCM Group was significantly lower than those in the WM Group. The combination of Chinese and western medicine in the treatment of cirrhosis can reduce the occurrence of complications, improve the clinical symptoms and improve the clinical effects effectively, which is worthy of further study and clinical popularization. Viral hepatitis B, Liver cirrhosis, Combination of TCM and Western medicine, miR-122, miR-200a.

摘要

目的

探讨中西医结合治疗乙型肝炎肝硬化的临床疗效及对微小 RNA(miR)-122 和 miR-200a 的影响。方法:选取我院收治的 116 例慢性乙型肝炎肝硬化患者,采用实时荧光定量 PCR(qPCR)检测三组患者血清 miR-122 和 miR-200a 水平。比较两组患者的临床疗效,包括丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、甲胎蛋白(AFP)指标、凝血功能指标、肝弹性值及主要治疗效果。结果:治疗后两组患者的 ALT、AST、TBIL 和 AFP 指标均明显降低,西药(WM)+中药组降低更明显。两组患者的白蛋白(ALB)水平均升高,WM+TCM 组升高更明显。两组患者的凝血酶原时间(PT)下调,凝血酶原活性(PTA)上调。两组患者治疗后肝弹性值均降低,WM+TCM 组降低更明显。WM+TCM 组原发性腹膜炎、肝性脑病、肝肾综合征、上消化道出血和电解质紊乱的发生率明显低于 WM 组。结论:中西药联合治疗肝硬化可减少并发症的发生,改善临床症状,提高临床疗效,值得进一步研究和临床推广。乙型肝炎,肝硬化,中西医结合,miR-122,miR-200a。

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