重肝合剂保留灌肠阻抑重型肝炎内毒素血症的临床研究

Clinical study about restraint of retention enema by Zhonggan mixture on endotoxemia in patients with severe hepatitis

目的:观察重肝合剂保留灌肠(滴灌法)对重型肝炎内毒素血症的阻抑效果。方法:将100例重型肝炎(亚急性、慢性重型乙型肝炎)按分层均衡、随机分组设计:治疗组50例(早期、中期重型肝炎各25例),对照组50例(早期、中期重型肝炎各25例)。治疗组采用重肝合剂保留灌肠+常规治疗,对照组采用乳果糖溶液保留灌肠+常规治疗。结果:治疗组与对照组比较:临床疗效优于对照组(P<0.05);治疗3周后血浆内毒素(ET)水平显著低于对照组(治疗3周组间比较P<0.05,治疗4周组间比较P<0.05);治疗3周后血浆肿瘤坏死因子(TNF-α)水平显著低于对照组(治疗3周组间比较P<0.05,治疗4周组间比较P<0.05)。结论:采用重肝合剂保留灌肠+常规治疗,是重型肝炎内毒素血症的较优治疗方法。重肝合剂保留灌肠对重型肝炎内毒素血症有较好的阻抑效果。

Objective： To observe the inhibitory effect of retention enema （drip method） by Zhonggan mixture on endotoxemia in the patients with severe hepatitis. Methods： One hundred patients with severe hepatitis （subacute or chronic hepatitis B） were randomly divided into two groups. The patients treated with both retention enema by Zhonggan mixture and routine therapy were considered as the treatment group, while 50 patients considered as the control group were treated with retention enema by lactulose solution and routine therapy. Both of them included 25 cases in early and middle stage of severe hepatitis respectively. Results： The clinical therapeutic effect in treatment group was better than that in control one （ P 〈 0. 05 ） . Also, compared with control group, the level both of endotoxin （ET） in plasma and the tumor necrosis factor （TNF-α） in plasma were notably lower in treatment group after 3 weeks （ P 〈 0. 05 ） . Conclusion： It is better to treat patients with severe hepatitis by retention enema by Zhonggan mixture and routine therapy. Zhonggan mixture has better effect on restricting endotoxemia in severe hepatitis.