石军牡蛎煎灌肠治疗湿热蕴结型慢性肝衰竭合并肝性脑病临床研究

The clinical study on enema treatment using Shijunmuli decoction for chronic liver failure combined with hepatic encephalopathy

目的:观察石军牡蛎煎灌肠联合西医基础疗法治疗慢性肝衰竭湿热蕴结证合并肝性脑病(HE)的临床疗效。方法:慢性肝衰竭湿热蕴结证合并HE患者74例,用随机数字法分为治疗组(37例)和对照组(37例),两组均给予西医基础治疗,治疗组患者予石军牡蛎煎灌肠,对照组患者予乳果糖溶液灌肠,治疗周期均为4周。4周后评价HE临床有效率、实验室指标、中医证候评分。结果:①治疗4周后,治疗组患者HE临床有效率为86.5%,对照组患者HE临床有效率为72.9%,差异有统计学意义(P<0.05)。②治疗4周后,治疗组患者TBil、ALT、AST、Alb、血氨较治疗前改善(P<0.05),对照组患者ALT、AST、血氨较治疗前改善(P<0.05),治疗组患者改善TBil、ALT、AST、Alb、血氨疗效优于对照组(P<0.05)。③治疗4周后,治疗组患者与对照组患者的PT、PTA较治疗前改善(P<0.05)。④治疗4周后,治疗组患者与对照组患者的中医证候侯评分较治疗前均降低(P<0.05),治疗组患者疗效优于对照组(P<0.05)。结论:石军牡蛎煎灌肠联合西医基础疗法治疗慢性肝衰竭湿热蕴结证合并HE能够提高HE临床疗效,改善肝功能及中医证候,疗效优于乳果糖溶液灌肠。

Objective:To observe the clinical effect of enema treatment using Shijunmuli decoction for chronic liver failure(dampness-heat stasis syndrome)combined with hepatic encephalopathy.Methods:A total of 74 patients with chronic liver failure combined with HE(damp-heat accumulation syndrome)were included and divided into a treatment group(37 cases)and a control group(37 cases)by random number method.Both groups were given basic western medicine treatment,and the treatment group was given Shijunmuli decoction clyster,the control group was given lactulose solution clyster,and the treatment cycle was 4 weeks.After 4 weeks of treatment,the clinical efficacy,laboratory indexes,and traditional Chinese medicine symptom scores of the two groups were evaluated.Results:After 4 weeks of treatment,the clinical effective rate of HE in the treatment group was 87%,and the clinical effective rate of HE in the control group was 73%.The curative effect of the treatment group was better than that of the control group,with statistical significance(P<0.05).TBil,ALT,AST,Alb,blood ammonia in the treatment group was improved compared with that before treatment(P<0.05).ALT,AST,blood ammonia in the control group was improved compared with that before treatment(P<0.05),and the curative effect of the treatment group was better than that of the control group,with statistical significance(P<0.05).The PT,PTA in the treatment group and the control group was improved compared with that before treatment,with statistical significance(P<0.05).The scores of middle symptom in both the treatment group and the control group were lower than those before treatment,and the curative effect of the treatment group was better than that of the control group,with statistical significance(P<0.05).Conclusion:Shijunmuli decoction clyster combined with western medicine basic therapy in the treatment of chronic liver failure with hepatic encephalopathy can improve the clinical effective rate,improve the liver function,kidney function and prothrombin,and the curative effect is better than the lactulose solution clyster group,and has achieved good clinical curative effect in clinical application.Shijunmuli decoction clyster combined with basic western medicine therapy in the treatment of chronic liver failure with hepatic encephalopathy(damp-heat accumulation syndrome)can improve the symptoms of traditional Chinese medicine,and the curative effect is better than the lactulose solution clyster group.