中医多途径给药对乙型肝炎慢加急性肝衰竭西医常规疗法的增效作用

Synergistic Effect of Multi-Ways Chinese Medication on Routine Therapy for Hepatitis B Virus Related Acute-On-Chronic Liver Failure

目的研究中医多途径给药对乙型肝炎慢加急性肝衰竭(HBV-ACLF)西医常规疗法的增效作用。方法将84例HBV-ACLF患者随机分为治疗组和对照组各42例,对照组采用西医常规疗法,治疗组在对照组基础上加用中医多途径给药,茵虎颗粒每日1剂,每次200ml,早晚2次口服;退黄灌肠液每日1剂,每次200ml,每日2次高位保留灌肠。两组均以1个月为1个疗程,2个疗程后比较两组患者临床疗效、难治性并发症发生率、人工肝治疗次数、患者住院时间,并于治疗前后检测患者肝功能、凝血酶原活动度(PTA)及血氨(AMDN)水平。结果治疗组总有效率为82.93%,对照组总有效率为62.50%,治疗组总有效率明显优于对照组(P<0.05)。治疗后两组肝功能、PTA及AMON均有明显改善(P<0.05或P<0.01),治疗组对各项指标的改善明显优于对照组(P<0.05或P<0.01)。治疗组出现难治性并发症、住院治疗时间及应用人工肝治疗次数均明显低于对照组(P<0.05)。结论中医多途径给药对西医常规疗法治疗HBV-ACLF有显著增效作用。

Objective To study the synergistic effect of multi-ways Chinese medication on routine therapy for hepatitis B vi- rus related acute-on-chronic liver failure （HBV-ACLF）. Methods Eighty four cases of HBV-ACLF were randomized into treatment group and control group, with 42 in each. The control group was given conventional therapy and the treatment group was added with multi-way Chinese medication, i.e. Yinhu Granules [-granules of Yinchen （Herba Arternisiae Scopariae） and Huzhang （Rhizoma et Radix Polygoni Cuspidati）] one dose daily, taken orally in the morning and evening, and Tuihuang Enema （jaundice-abating enema） one dose each day for high retention enema twice. One treatment course lasted for one month. The effect was observed after 2 courses of treatment. Results The total effective rate of the treatment group and control group was 82.93M and 62.50M respectively, with significant difference Between groups （P^0.05）. The liver function, prothrom- bin activity （PTA） and ammonia （AMON） were significantly improved in both groups after treatment （P〈0.01 or P〈0.05）, especially in the treatment group （P^0. 01 or P^0.05）. The refractory complications, hospitalization times and the times of artificial liver treatment were significantly reduced in the treatment group, with significant difference between groups （P^O. 05）. Conclm~）n The multi-ways Chinese medication has obvious synergistic effect for HBV-ACLF on the basis of conventional therapy.