抗肝衰复方联合人工肝治疗对慢加急性肝衰竭湿热瘀阻证患者血清炎症因子及预后的影响

Effect of Anti-Liver Failure Compound Combined with Artificial Liver Treatment on Serum Inflammatory Factors and Prognosis in Patients with Damp Heat and Blood Stasis Syndrome in Acute-on-Chronic Liver Failure

摘要: 目的：观察抗肝衰复方联合人工肝治疗对慢加急性肝衰竭(ACLF)患者血清降钙素原(PCT)、白介素-6 (IL-6)、血清丛生蛋白(Clusterin)、趋化因子受体5 (CCR5)和预后的影响。方法：85例慢加急性肝衰竭患者随机分成两组，其中试验组43例，对照组42例；两组患者均给予人工肝治疗及常规西医治疗，试验组在此基础上加用抗肝衰复方治疗；治疗疗程为4周，并在第12周随访，比较两组治疗前后中医证候评分、肝功能指标、凝血功能指标、炎症因子指标及预后结局。结果：试验组治疗后乏力、腹胀中医证候积分及总积分、MELD评分比对照组同期更低(p < 0.05)；试验组治疗后肝功能及凝血功能均较之前明显好转(p < 0.05)，但组间比较差异无统计学意义(p > 0.05)；试验组血清PCT、IL-6、Clusterin、CCR5均较治疗前明显好转，差异具有统计学意义(p < 0.05)，与对照组同期相比，试验组Clusterin、CCR5上升更显著(p < 0.05)；试验组第12周死亡人数少，生存率更高，差异具有统计学意义(p < 0.05)。结论：抗肝衰复方联合人工肝治疗慢加急性肝衰竭具有较好的临床疗效，尤其是改善消化道症状方面，可能与减轻机体炎症反应有关。

Abstract: Objective: Observe the effect of anti-liver failure compound combined with artificial liver on serum procalcitonin (PCT), interleukin-6 (IL-6), serum clusterin, chemokine receptor 5 (CCR5), and prognostic implications in patients with acute-on-chronic liver failure. Methods: 85 patients with acute-on-chronic liver failure were randomly divided into two groups, including 43 cases in the experimental group and 42 cases in the control group. Both groups of patients were given artificial liver treatment and conventional Western medicine treatment, and the experimental group was additionally treated with an anti-liver failure compound; the treatment course was 4 weeks, and follow-up was conducted in the 12th week. The TCM syndrome scores, liver function indicators, coagulation function indicators, inflammatory factor indicators, and prognosis outcomes were compared between the two groups before and after treatment. Results: After treatment, the experimental group’s fatigue, abdominal distension, TCM syndrome scores, total scores, and MELD scores were lower than those of the control group during the same period (p < 0.05); after treatment, the liver function and coagulation function of the test group were significantly improved (p < 0.05), but the difference between the groups was not statistically significant (p > 0.05); the serum PCT, IL-6, Clusterin, and CCR5 in the experimental group were significantly improved compared with those before treatment, and the difference was statistically significant (p < 0.05). Compared with the control group in the same period, In comparison, the increase in Clusterin and CCR5 in the experimental group was more significant (p < 0.05); the number of deaths in the experimental group at week 12 was lower and the survival rate was higher, and the difference was statistically significant (p < 0.05). Conclusion: The anti-liver failure compound combined with artificial liver has good clinical efficacy in the treatment of acute-on-chronic liver failure, especially in improving gastrointestinal symptoms, which may be related to reducing the body’s inflammatory response.