消黄方联合西药治疗难治性黄疸51例临床观察

Clinical observation of "Xiaohuang Decoction" plus western medicine in treating 51 cases of refractory jaundice

目的观察消黄方联合西药治疗难治性黄疸的临床疗效。方法将104例难治性黄疸患者随机分为治疗组53例(脱落2例),对照组51例(脱落1例)。对照组中重度黄疸者口服甘草酸二铵、丁二磺酸腺苷蛋氨酸、熊去氧胆酸胶囊,轻度黄疸者口服水飞蓟素胶囊、熊去氧胆酸胶囊;治疗组在对照组治疗方案的基础上加服消黄方。治疗12周后,观察中医证候积分、肝功能,并评价临床疗效。结果治疗组、对照组总有效率分别为68.64%、48.65%(P<0.05)。治疗组治疗后身目黄染、脘痞腹胀、神疲乏力、食欲不振积分、总积分及TBiL、DBiL、TBA、ALT、AST均较治疗前降低(P<0.05,P<0.01);且治疗组治疗后脘痞腹胀积分、总积分、TBil、Dbil均低于对照组同期(P<0.05)。结论消黄方联合西药治疗难治性黄疸疗效良好。

Objective To study the therapeutic effect of ＂Xiaohuang Decoction＂ plus western medicine in treating refractory jaundice.Methods 104 patients with refractory jaundice were randomly divided into control group（n=51） and treatment groups（n=53）.Patients with severe jaundice in the control group were treated with diammonium glycyrrhizinate,ademetionine and ursofalk,while those with mild jaundice were given silybin and ursofalk.Patients in the treatment group received ＂Xiaohuang Decoction＂ besides the same treatments as the control group.Both groups received treatment for 12 weeks.The scores of TCM syndromes were counted,and the levels of serum TBIL,DBIL,ALT,AST,ALP and TBA were measured.Results The total effective rates in the treatment group and the control group were 68.64%and48.65% respectively.The efficacy in treatment group was more superior to that in the control group（P〈0.05）.In treatment group,the scores of jaundice,abdominal distension,hypodynamia,decrease diet,and the total score,and the levels of serum TBIL,DBIL,TBA,ALT and AST after treatment were lower than those before treatment（P〈0.01 or P〈0.05）.The scores of abdominal distension,total score,and the levels of serum TBil and DBil in the treatment group were significantly lower than those in control group after 12 weeks（P〈0.05）.Conclusion ＂Xiaohuang Decoction＂ plus western medicine is effective in treating refractory jaundice.