抗肝衰复方联合西药治疗重型肝炎临床疗效观察

Clinical effect on severe hepatitis treated by compound anti-fulminant hepatitis

目的：评价抗肝衰复方对急性、亚急性、慢性重型肝炎患者的临床治疗效果。方法：随机选择120例重型肝炎患者将其分为两组，对照组60例采用《病毒性肝炎防治方案》确定的常规西药治疗，治疗组60例在常规西医治疗基础上加用抗肝衰复方（药物口服和／或灌肠）治疗，100ml／次，1剂／d，14天为1个疗程，连用3—4个疗程。观察临床症状、体征变化，比较肝功能、乙肝病毒血清标志物及常规生化指标改善情况，研究抗肝衰复方对重型肝炎患者主要并发症的干预效果，统计治疗的有效率及存活率。结果：治疗组有效率71．7％。显效率为48．3％，对照组有效率为51．7％，显效率为20.2％，差异均有显著性意义（P〈0.05或P〈0．01）；治疗3个疗程后患者乏力、上腹不适、恶心、纳差、腹胀等临床症状及体征迅速缓解，血清总胆红素（TBil）、天门冬氨酸转氨酶（AST）、凝血酶原活动度（PTA）也明显改善，差异均有显著性意义（P〈0．05或P〈0．01）。而丙氨酸转氨酶（ALT）与对照组比较也有下降，但差异无显著性意义（P〉0．05）。并发症在治疗3个疗程后均少于对照组，肝性脑病、肝肾综合征等并发症减少较对照组差异有显著性意义（P〈0.05）；治疗3个疗程后HBVDNA、HBeAg定量滴度与对照组比较均有加速下降趋势，但差异无显著性意义（P〉0．05）。结论：抗肝衰复方有助于改善急性、亚急性、慢性重型肝炎患者的预后，是提高整体治疗重型肝炎疗效的有效措施之一。

Objective： To evaluate clinical effect of compound anti-fulminant hepatitis in acute, subacute and chronic fulminant hepatitis. Methods： One hundred and twenty cases of fulminant hepatitis were selected at random and divided into 2 groups, 60 cases in control group were treated with western medicine according to Diagnosis and treatment plan of viral hepatitis, 60 cases in treatment group were treated combined with western medicine and compound anti-fulminant hepatitis （ orally taken and /or enema）, which was taken 100 ml each time, 1 time a day and 14 days as a treating course. The patients were treated 3-4 treating course. Their clinical manifestation, clinical signs and result of liver function test, seral markers of hepatitis B were observed and compared. The interpose effect of compound anti-fulminant hepatitis on the cases of fulminant hepatitis with primary complication were studied. The total effective rate and survival rate were counted. Results： The marked improvement rate was 48.3% and total effective rate was 71.7% in treatment group, compared to 20. 0% and 51.7% in control group. The diffecence was significant （P 〈0.05 or P 〈0. 01 ）. The cases complications in treatment group were less than those in control group. The difference was significant （ P 〈 0. 05 ）. The improvement of TBil, AST and PTA in treatment group was greater than those of in control group. The difference was significant （ P 〈 0. 05 or P 〈 0. 01 ）. The levels of ALT, HBV DNA and HBeAg quantitative in treatment group were less than those in control group. The difference was not significant （ P 〉 0.05 ）. Conclusion ： The compound anti-fulminant hepatitis was helpful to improve prognosis of acute, subacute and chronic fulminant hepatitis and is one of the effective measures to improve overall treatment of fulminant hepatitis.