| 陈晓东,李甫.大柴胡汤加减通过调控TLR4/NF-κB信号通路治疗原发性胆汁性胆管炎的效果观察[J].安徽医药,待发表. |
| 大柴胡汤加减通过调控TLR4/NF-κB信号通路治疗原发性胆汁性胆管炎的效果观察 |
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| 投稿时间：2025-05-11 录用日期：2025-06-12 |
| DOI： |
| 中文关键词: 柴胡 原发性胆汁性胆管炎 信号通路 Toll样受体 核因子-κB 肝功能 |
| 英文关键词: |
| 基金项目:上海市科委“科技创新行动计划”临床医学领域项目(19401972400) |
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| 中文摘要: |
| 目的? 探讨大柴胡汤加减通过调控Toll样受体4/核因子-κB(TLR4/NF-κB)信号通路治疗原发性胆汁性胆管炎(PBC)的效果。方法 选取2020年1月～2024年12月我院100例PBC患者,随机分为两组,各50例。西医组予以熊去氧胆酸片(UDCA),联合组于此基础上,联合采用大柴胡汤加减治疗,均治疗3个月。比较两组临床疗效、TLR4/NF-κB信号通路相关蛋白、mRNA表达(TLR4、NF-κB p50、NF-κB p65)、细胞因子水平[白细胞介素-6(IL-6)、IL-1β、肿瘤坏死因子-α(TNF-α)]、肝功能指标[天冬氨酸转移酶(AST)、丙氨酸转移酶(ALT)、γ-谷氨酰转移酶(GGT)、总胆红素(TBIL)]及不良反应。结果? 联合组的临床总有效率显著高于西医组(92.00% vs 76.00%)(P＜0.05)；治疗后,联合组TLR4、NF-κB p50及NF-κB p65 mRNA及蛋白表达低于西医组(P＜0.05)；治疗后,联合组IL-1β、IL-6、TNF-α水平低于西医组(P＜0.05)；治疗后,联合组GGT、ALT、TBIL、AST水平较西医组降低(P＜0.05)；联合组不良反应发生率与西医组(14.00% vs 10.00%)比较无显著差异(P＞0.05)。结论? 大柴胡汤加减联合熊去氧胆酸治疗PBC疗效显著,能有效改善患者肝功能,降低炎症因子水平,其作用机制可能与抑制TLR4/NF-κB信号通路活化有关,且安全性良好。 |
| 英文摘要: |
| Objective ?To investigate the therapeutic effect of modified Dachaihu decoction on primary biliary cholangitis (PBC) through regulating the Toll-like receptor 4/nuclear factor-kappa B (TLR4/NF-κB) signaling pathway. Methods ?One hundred patients with PBC in our hospital from January 2020 to December 2024 were selected and randomly divided into two groups, with 50 patients in each group. The western medicine group was given ursodeoxycholic acid tablets (UDCA), and the combined group was treated on this basis with the combination of Modified Dachaihu decoction, both treated for 3 months. The clinical efficacy, proteins related to the TLR4/NF-κB signaling pathway, mRNA expression (TLR4, NF-κB p50, NF-κB p65), cytokine levels [interleukin-6 (IL-6), IL-1β, tumor necrosis factor-α (TNF-α)], liver function indicators [aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyltranspeptidase (GGT), total bilirubin (TBIL)], and adverse reactions were compared between the two groups. Results The total clinical efficacy rate in the combined group was significantly higher than that in the Western medicine group (92.00% vs 76.00%) (P<0.05). After treatment, the mRNA and protein expressions of TLR4, NF-κB p50, and NF-κB p65 in the combined group were lower than those in the Western medicine group (P<0.05). After treatment, the levels of IL-1β, IL-6, and TNF-α in the combined group were lower than those in the Western medicine group (P<0.05). After treatment, the levels of GGT, ALT, TBIL, and AST in the combined group were lower than those in the Western medicine group (P<0.05). There was no significant difference in the incidence of adverse reactions between the combined group and the Western medicine group (14.00% vs 10.00%) (P>0.05). Conclusion The combination of modified Dachaihu decoction and ursodeoxycholic acid exhibits significant efficacy in the treatment of PBC, effectively improving patients" liver function and reducing inflammatory factor levels. Its mechanism of action may be related to the inhibition of TLR4/NF-κB signaling pathway activation, and it demonstrates good safety. |
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