鲜地黄联合人工肝治疗慢性重型肝炎疗效研究

The Efficacy of Fresh Rehmannia Juice and Artificial Liver Support System in Treating Patients with Chronic Severe Hepatitis

目的研究口服鲜地黄汁联合人工肝支持系统对慢性重型肝炎的治疗效果。方法将48例患者随机分为两组,在给予重型肝炎综合治疗及人工肝治疗的基础上,治疗组给予鲜地黄汁,每日60ml分服;对照组给予乳果糖口服,每次10ml,每日3次。分别于治疗前及治疗后2周观察患者症状、肝功能、凝血酶原活动度及血清内毒素、细胞因子(TNF、IL-1β)变化。结果治疗前慢性重型肝炎口干发生率高达81.40%,腹胀发生率为67.44%,内毒素血症发生率为100%。经治疗,两组症状均有所好转,胆红素、内毒素、细胞因子下降,凝血酶原活动度回升。与对照组比较,治疗组在口干舌燥、大便干结、胆红素下降、凝血酶原活动度回升、内毒素下降及细胞因子下降等方面均优于对照组(P<0.05或P<0.01)。结论鲜地黄可促进排便,有效降低血清内毒素及促炎性细胞因子水平,促进胆红素下降,缩短凝血酶原时间,减少严重出血的危险,并可改善口干舌燥等症状。

Objective To study the efficacy of fresh rehmannia juice and artificial liver support system in treating patients with chronic severe hepatitis. Methods 48 patients with chronic severe hepatitis were divided into two groups （trial group and control group） randomly and treated with comprehensive management and artificial liver treatment. The patients in treatment group were received fresh rehmannia juice 60 ml （trial group, n = 24）, and the patients in control group were treated with lactulose 30 all （control group, n =24） every day for 2 weeks. The changes of symptom, liver function, PTA, serum endotoxin, TNF and IL-β were observed before and after the treatment. Results The incidences of dry mouth, abdominal distention and endotoxemia are 81.40% , 67.44% and 100% respectively. After treatment, these symptoms and the levels of Bil, PTA, ET and TNF in all patients have been improved. But the efficacy of trial group is superior to that of control group （ P 〈 0.05 or P 〈 0.01 ）. Conclusion Fresh rehmannia juice can promote defecation, decrease the levels of serum endotoxin, proinflammatory cytokines and bilirubin, shorten prothrombin time and improve the symptoms.