Objective: To observe the curative effect of colon-targeted Huchang Qingdu pellets in blocking intestinal endotoxemia in patients with HBV-related acute on chronic liver failure

and investigate the possible mechanism.Method: Totally 120 cases of HBV-related acute on chronic liver failure with intestinal endotoxemia (IETM) and syndrome of interior stasis toxin were collected from January 2013 to October 2016.According to double-blind double-dummy randomized control principle

these patients were divided into oral colon-targeted Huchang Qingdu pellets group

lactulose group and control group

with 40 cases in each group. Some clinical indices

such as traditional Chinese medicine (TCM) clinical symptom score

plasma endotoxin

tumor necrosis factor-α(TNF-α)

interleukin (IL)-1

IL-6

IL-8

plasma D-lactic acid

plasma diamine oxidase (DAO)

coagulation function and L/M were observed before and after treatment. And differences among the three groups were compared.Result: The clinical indices of TCM syndrome integral

plasma endotoxin

inflammatory cytokines

plasma D-lactic acid

and plasma diamine oxidase in treatment groups were significantly superior to those before treatment and in control group (P<0.05). Colon-targeted Huchang Qingdu pellets group was more effective than lactulose group in TCM syndrome score

TBIL

PA

PTA

plasma endotoxin

inflammatory cytokines

plasma D-lactic acid

and plasma diamine oxidase (P<0.05).Conclusion: Colon-targeted Huchang Qingdu pellets can inhibit the release of inflammatory cytokine

correct the permeability of the intestinal mucosa

regulate blood coagulation function and internal environment

so as to effectively prevent the occurrence of intestinal endotoxemia

a repair liver tissue injury

with a better overall effect than lactulose.