Effect of Wenyang Huazhuo Tuihuang decoction on treatment of HBV infection-associated acute-on-chronic liver failure and impact on expressions of PD-1/PD-L1
OBJECTIVE To observe the effect of Wenyang Huazhuo Tuihuang decoction on treatment of hepatitis B virus(HBV)infection-associated acute-on-chronic liver failure(ACLF)and analyze the impact on liver function indexes and expression levels of programmed death factor-1/programmed death factor ligand-1(PD-1/PD-L1).METHODS A total of 86 patients with HBV infection-associated ACLF were randomly divided into the group A and the group B,with 43 cases in each group.The group A was given conventional therapy,the group B was trea-ted with Wenyang Huazhuo Tuihuang decoction on basis of the therapy of the group A.Both groups were treated for 8 consecutive weeks.The clinical therapeutic effects,liver function indexes,PD-1/PD-L1,model for end-stage liver disease(MELD)score and safety were observed and compared between the two groups.RESULTS After the treatment for 8 weeks,the total effective rate of the group B was 76.74％,higher than 44.19％of the group B(P＜0.05).The levels of serum glutamic oxaloacetic transaminase(GOT),direct bilirubin(DBIL),peripheral blood CD4+PD-1+,CD4+PD-L1+,CD8+PD-1+and CD8+PD-L1+of the two groups were lower after the treat-ment than before the treatment(P＜0.05),and the levels of the above indexes of the group B were lower than those of the group A(P＜0.05).The levels of serum albumin(ALB)and cholinesterase(CHE)of the two groups were higher after the treatment than before the treatment(P＜0.05),and the levels of the above indexes of the group were higher than those of the group A(P＜0.05).The MELD score of the two groups was lower after the treatment for 4 and 8 weeks than before the treatment(P＜0.05),the MELD score was lower after the treat-ment for 8 weeks than after the treatment for 4 weeks(P＜0.05),and the MELD score of the group B was lower than that of the group A(P＜0.05).There were no severe adverse reactions in both groups during the treatment.CONCLUSION Wenyang Huazhuo Tuihuang decoction can effectively reduce the MELD score of the patients with HBV infection-associated ACLF,boost the liver function and reduce the expression levels of PD-1/PD-L1 so as to improve the clinical therapeutic effect,with the safety favorable.
Hepatitis B virusAcute-on-chronic liver failureWenyang Huazhuo Tuihuang decoctionLiver func-tionProgrammed death factor-1Programmed death factor ligand-1
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