中药高位保留灌肠联合西药治疗慢性乙型肝炎肝功能衰竭湿热发黄证患者近期疗效

Short-term Effect of Herbal Decoction High Position Retained Enema Combined with Western Drug Treatment on Patients with Damp-heat Jaundice of Chronic Hepatitis B Related Acute Liver Failure

目的评价中药高位保留灌肠对慢性乙型肝炎肝功能衰竭(肝衰竭)患者的早期疗效。方法 50例慢性乙型肝炎肝衰竭早期属中医湿热发黄证患者随机分为治疗组25例和对照组25例。对照组患者给予内科综合治疗;治疗组在此基础上予以中药保留高位灌肠,每日1次,疗程2周。比较两组患者治疗后临床疗效、两组有效患者治疗后腹胀改善时与黄疸消退时间、血清总胆红素(TBiL)、凝血酶原活动度(PTA)的变化。结果治疗组有效率为68%,对照组为40%,两组比较差异有统计学意义(P<0.05)。两组有效患者治疗后较治疗前TBiL明显下降(P<0.05),PTA明显升高(P<0.05);TBiL的下降和PTA的上升治疗组均优于对照组,差异有统计学意义(P<0.05)。治疗组治疗后腹胀改善时间、黄疸消退时间均少于对照组,差异有统计学意义(P<0.05)。结论对于慢性乙型肝炎肝衰竭证属湿热发黄证患者,在内科综合治疗的基础上,尽早予以中药高位保留灌肠有利于控制病情进展,改善预后。

Objective To evaluate the short-term effect of herbal decoction high position retained enema on the patients with chronic hepatitis B related acute liver failure.Methods Fifty cases with chronic hepatitis B related acute liver failure were randomized into treatment group and control group,25 in each.The control group was treated with comprehensive medication,based on which,the treatment group was given herbal decoction high position retained enema,once a day.The course of treatment was of two weeks.The therapeutic effect,the improvement of abominal distention and jaundice,serum total BiLirubin（TBiL）,and prothrombin activity（PTA）of the two groups were compared.Results The effective rate of the treatment group was 68% and that of the control group was 40%,there was significant difference between（P0.05）.TBiL of improved patients of both groups after treatment was significantly decreased（P0.05）,while the PTA was significantly increased（P 0.05）.The falling of TBiL and the rising of PTA were both better than those of the control group,there was statistical difference（P0.05）.Time of improvement of abdominal distention and time of jaundice elimination in the treatment group were both shorter than those of the control group,there was difference in statistics（P0.05）.Conclusion For the patients with damp-heat jaundice of chronic hepatitis B related acute liver failure,the herbal decoction high position retained enema should be given as early as possible based on the comprehensive medication.It＇s of benefit to controlling the development of pathological condition and improving the prognosis.