白蛋白偏低怎样治疗

白蛋白偏低如何治疗配图，仅供参考

5. Treatment of LCH
# 5.1. Modern Medical Treatment of LCH
5.1.1. Antivirus
Antiviral therapy is the most routine intervention in the treatment of LCH in modern medicine . Antiviral drugs can reduce hepatitis B (HBV) replication,prevent further necrosis of liver cells,improve liver function to varying degrees,promote the recovery of liver synthesis function,and increase serum albumin concentration. Shang reported the application of lamivudine combined with conventional liver protection measures to treat 93 patients with cirrhosis and hypoalbuminemia,and serum albumin increased significantly after 6 months of treatment. Lamivudine can significantly improve the liver function of patients with liver cirrhosis and increase the level of serum albumin. Another group of clinical controlled studies have shown that entecavir has strong anti-hepatitis B virus activity and is well tolerated . It can effectively inhibit HBV replication,reduce hepatocyte inflammatory response,and improve vascular endothelial cell function. The treatment effect for hypoproteinemia,abdominal effusion,and portal hypertension is remarkable.
5.1.2. Human Albumin or Plasma Infusion
Infusion of human albumin or plasma is currently one of the most commonly used methods for the treatment of hypoalbuminemia in liver cirrhosis. A number of studies have clearly shown that albumin can effectively improve hemodynamic disorders and various complications caused by advanced liver cirrhosis. All exhibited this common characteristic. Salerno et al. confirmed the efficacy of albumin in improving the outcome of SBP patients through meta-analysis and significantly improved the survival rate of hospitalized patients. When liver cirrhosis is complicated by HRS,albumin combined with vasoconstrictor (mainly Terlipressin) can improve the survival of patients in a short period of time. It can improve renal function in about 40% of cases and cure HRS in about 30% of cases . Bernardi et al. analyzed 17 trials and found that albumin infusion was more effective in reducing circulatory dysfunction after paracentesis and reducing the incidence and mortality of ascites compared with conventional therapy.
However,due to the lack of clear clinical data and clinical efficiency evaluation,the role of albumin in some complications of liver cirrhosis has been controversial. For example,there is little evidence on the effect of albumin fold treatment in patients with non-SBP-related infections. A recent randomized study showed that treatment with albumin in combination with antibiotic improved the circulation and renal function in patients,but it was not observed between the two groups. It has a significant effect on the incidence of renal failure,and there is no difference in the 3-month cumulative survival rate. Therefore,further studies are needed to elucidate the therapeutic effect of albumin under this condition . Although clinical studies have shown that transfusion of human albumin is beneficial in patients with severe HE,it is unclear whether cirrhosis complicated by hepatic encephalopathy is an indication for albumin due to the lack of clear clinical efficacy evaluation.
5.1.3. Amino Acid Supplementation
When hypoalbuminemia occurs in liver cirrhosis,the metabolism of amino acids and proteins in the body is mainly manifested as increased blood ammonia,decreased plasma albumin,and changes in the amino acid profile in the blood. Studies have shown that,in the amino acid metabolism disorder in the early stage of liver disease,the main reason is the reduction of branched chain amino acids (BCAA). Branched chain amino acids are essential raw materials for human protein synthesis and can be used as applied substances to provide the body with the necessary energy supply and reduce protein breakdown . Clinically,compound amino acid injection has a wide variety of uses due to different uses. Amino acid injection has a high proportion of branched chain amino acids,which can help correct the imbalance of various amino acid ratios in patients with liver cirrhosis. It is often used for nutritional support treatment of patients with liver cirrhosis. Clinical studies have shown that the serum albumin concentration of patients with liver cirrhosis increases significantly after using branched chain amino acids,the incidence of ascites decreases,and the Child-Pugh score is reduced . Ohno et al. confirmed through long-term clinical trials that supplemental therapy with branched chain amino acids can increase serum albumin levels in patients with liver cirrhosis and reduce the risk of HCC and other complications .
5.1.4. Recombinant Human Growth Hormone
Growth hormone is a hormone secreted by the anterior pituitary gland,which can promote liver cell regeneration and albumin synthesis. It is difficult to obtain natural growth hormone. Artificially synthesized recombinant human growth hormone is commonly used in clinical practice,which has exactly the same structure and function as natural growth hormone. Recombinant human growth hormone can reverse the negative nitrogen balance and has an obvious “nitrogen storage” effect,thereby stimulating the expression of liver cell protein mRNA and increasing the bodys protein level. Studies have shown that patients with liver cirrhosis have severe growth hormone resistance,and their serum GH levels are elevated,leading to reduction of the levels of IGF-1 and insulin-like growth factor binding protein-3 (IGFBP-3). Exogenous recombinant human growth hormone can overcome growth hormone resistance and increase the level of IGF-1 and IGFBP-3. IGF-1 can inhibit protein breakdown and increase amino acid intake and cell proliferation,and IGFBP-3 can upregulate the biological activity of IGF-1 and further promote anabolism. Luo et al. explored the effect of recombinant human growth hormone (rhGH) on the residual liver after hepatectomy in 24 patients with cancer and cirrhosis. The results showed that hepatic functional damage immediately after hepatectomy is a significant risk factor for early intrahepatic recurrence in cirrhotic HCC. The rhGH can promote the recovery of liver function by reducing the decline of cellular immune function in patients with liver cancer and liver cirrhosis and can also promote the bodys protein synthesis and liver regeneration.
# 5.2. Traditional Medicine Treatment for LCH
5.2.1. Fubai Formula
Traditional Chinese medicine (TCM) believes that albumin belongs to the subtle category of qi and blood,while the spleen is the official source of qi and blood. Modern medicine shows that the drugs in Fubai prescription can not only directly supplement albumin but also reduce liver cell degeneration and necrosis,improve liver microcirculation,inhibit fibrous tissue proliferation,and significantly increase the infiltration of 3H-leucine into serum and liver to participate in protein synthesis,thereby improving the albumin level . Shi et al. analyzed the syndrome characteristics of patients with liver cirrhosis and hypoalbuminemia and the treatment effect of TCM,and the results showed that Fubai formula was significantly better than the control group in terms of TCM symptom improvement and serum albumin normalization rate. The long-term effect was more significant and no adverse reactions were seen. Serum cholinesterase (ChE) can sensitively and specifically reflect the anabolic function of the liver,and it is a sensitive indicator for evaluating the protein synthesis function of liver cells . Xue explored the effect of Fubai prescription on serum cholinesterase activity in patients with hepatitis and liver cirrhosis and found that the efficacy of Fubai prescription was significantly better than that of the control group. This is mainly related to the complex of Fubai Fang in promoting hepatocyte regeneration and eliminating immunity and increasing the activity of serum ChE.
5.2.2. Wuji Baifeng Pills
The prescription contains 30% black-bone chicken and is matched with Ginseng Radix et Rhizoma and Astragali Radix to invigorate qi and promote fluid. It is supplemented with Chuanxiong Rhizoma,Angelicae Sinensis Radix,Paeoniae Radix Alba,and Rehmanniae Radix Praeparata to nourish qi and blood,regulate menstruation,and relieve pain,and Cyperi Rhizoma,Dioscoreae Rhizoma,and Cervi Cornus Colla are added to regulate qi and invigorate the spleen and antler gum,as well as nourishing blood and yang. Hu et al. showed that Wuji Baifeng Pill can protect liver cells from damage and regulate amino acid imbalance. It is also conducive to the synthesis of albumin and forms a virtuous circle. The study by Zhan et al. and other studies have shown that the Wuji Baifeng Pill treatment group can improve the clinical symptoms,liver function,and blood coagulation function of patients more effectively than the control group and increase the serum total protein and albumin content of the patient. The total effective rate of the treatment group is 83.3%,was significantly higher than that of the control group (53.1%),and there were no adverse reactions during treatment. Therefore,Wuji Baifeng Pill is an ideal drug prescription for treating LCH. The main prescriptions of the TCM are listed in [Table 1](https://ncbi.nlm.nih.gov/pmc/articles/PMC8893996/table/tab1/) .
# Table 1
The main prescriptions of the TCM.


Prescription name
Composition
Effects



Fubai formula [ 33,36 ]
Poria,Atractylodis Macrocephalae Rhizoma,Astragali Radix,Angelicae Sinensis Radix,Bubali Cornu,Atractylodis Macrocephalae Rhizoma,Asini Corii Colla,Broussonetiae Fructus
Alleviating the symptoms of patients with liver cirrhosis and hypoalbuminemia,increasing the serum albumin content of patients,and improving the activity of serum cholinesterase in patients


Wuji Baifeng Pills [ 37 ]
Wuji,Cervi Cornus Colla,Trionycis Carapax,Ostreae Concha,Mantidis Ootheca,Ginseng Radix et Rhizoma,Astragali Radix,Angelicae Sinensis Radix,Paeoniae Radix Alba,Cyperi Rhizoma,Asparagi Radix,Glycyrrhizae Radix et Rhizoma,Rehmanniae Radix Praeparata,Rehmanniae Radix,Chuanxiong Rhizoma,Stellariae Radix,Salviae Miltiorrhizae Radix et Rhizoma,Dioscoreae Rhizoma,Euryales Semen,Cervi Cornu Degelatinatum
Protecting and improving liver cell function,reducing tyrosine production,promoting tyrosine degradation,and promoting albumin synthesis


Shengbai decoction [ 39 ]
Astragali Radix,Drynariae Rhizoma,Codonopsis Radix,Cuscutae Semen,Lycii Fructus,Spatholobi Caulis,Polygoni Multiflori Radix,Angelicae Sinensis Radix,Rehmanniae Radix Praeparata
Increasing the levels of albumin and insulin growth factor-1 in patients with liver cirrhosis and downregulating the serum levels of leptin and growth hormone


Qijia Chaizhu decoction [ 40,41 ]
Astragali Radix,Rhizoma Atractylodis,Gizzard Pepsin,Polygonum viviparum,Turtle Shell,Rehmannia muta,Angelica sinensis,Salvia miltiorrhiza

Improving symptoms,signs,liver function,serum albumin,and ultrasonographic findings in patients with liver cirrhosis



[Open in a separate window](https://ncbi.nlm.nih.gov/pmc/articles/PMC8893996/table/tab1/?report=objectonly)
5.2.3. Shengbai Decoction
Ye and Wu used liver hydrolyzed peptide intravenous infusion on the basis of routine liver protection,enzyme reduction,support,and diuresis,and the treatment group received Shengbai decoction with significantly better therapeutic effect than the control group. The treatment group was better than the control group in terms of restoring biochemical indicators,inhibiting HBV-DNA and HBeAg negative,and improving Child-Pugh score was also significantly higher than the control group. Zhu et al. have shown that Shengbai decoction is better than the control group in improving the clinical symptoms of patients and improving the survival rate of patients. This may be related to the reduction of GH and LEP levels,improvement of insulin resistance,and adjustment of IGF-Ι and GH. The negative feedback is related to the increased albumin level.
5.2.4. Qijia Chaizhu Decoction
Kong et al. compared the efficacies of Qijia Chaizhu decoction and conventional liver-protecting therapy in 60 patients with clinical liver cirrhosis and hypoproteinemia. The results showed that Qijia Chaizhu decoction could significantly improve the symptoms of patients with liver cirrhosis and restore serum indicators,such as ALT,TBil,and DBil. Compared with the control group,the curative effect is significant,with an effective rate of 83.33%,which has a significant therapeutic effect on patients with liver cirrhosis and hypoproteinemia.","department":"