中药联合血浆置换治疗慢性重型肝炎的临床研究

Clinical Study on Therapeutic Efficacy of Traditional Chinese Medicine(TCM) Combined With Plasma Exchange on Chronic Severe Hepatitis

目的探讨中药联合血浆置换治疗早、中期慢性重型肝炎的疗效。方法将86例早、中期慢性重型肝炎住院患者随机分成治疗组45例和对照组41例。对照组给予内科综合治疗及血浆置换,治疗组加用中药,比较两组患者在治疗第8周末的主要临床症状改善情况、肝功能、凝血功能、血浆置换次数及其疗效等情况。结果治疗组症状改善优于对照组(P<0.01);治疗组总有效率为84.44%,对照组总有效率为63.41%,两组总有效率比较差异有统计学意义(P<0.05);治疗组总胆红素(TBiL)与对照组治疗后比较有非常显著性意义(P<0.01)。治疗组进行血浆置换(4.0±1.2)次,对照组进行(4.6±1.4)次,两组比较差异有统计学意义(P<0.05)。结论中药联合血浆置换治疗早、中期慢性重型肝炎可明显改善症状,促进胆红素的代谢,减少血浆置换的次数,取得较好疗效。

Objective To evaluate the therapeutic efficacy of traditional Chinese medicine（TCM） combined with plasma exchange on chronic severe hepatitis. Methods Eighty-six inpatients with chronic severe hepatitis in the early or middle stage were randomly divided into a treatment group（n=45） and a control group（n=41）. The control group received conventional internal medicine therapy combined with plasma exchange, while the treatment group received TCM therapy additionally. After eight weeks’therapy, we compared the clinical effectiveness between the two groups in terms of the following contents, such as the alleviation of the main clinical symptoms, the serum level of liver function and blood coagulation function, the frequency of plasma exchange. Results Symptoms were alleviated more greatly in the patients of the treatment group than that of the control group （P〈0.01）. The total effective rate in treatment group was 84.44%,much higher than that （63.41%） in control group （63.41%,P〈0.05）. The serum level of TBil were alleviated more greatly in the patients of the treatment group than that of the control group （P〈0.01）. The frequency of plasma exchange was 4.0±1.2 in the treatment group,and 4.6±1.4 in the control group,with a significant difference between the two groups（P〈0.05）. Conclusions The combination therapy of TCM and plasma exchange can markedly relieve symptoms, enhance metabolism of TBil and reduce the frequency of plasma exchange. It achieves good therapeutic efficacy in the treatment of chronic severe hepatitis in the early or middle stage.