川芎嗪联合中药治疗胆道闭锁Kasai术后临床观察

Clinical Observation of Ligustrazine and Chinese Herbs in Treating Childhood Biliary Atresia After Kasai Operation

目的:观察川芎嗪联合中药治疗胆道闭锁肝门空肠吻合(Kasa)i术后的临床疗效。方法:将40例胆道闭锁Kasai术后患儿分为治疗组和对照组各20例,对照组予西医基础治疗,治疗组在对照组治疗的基础上加用静脉滴注川芎嗪及口服健脾化湿、温阳活血中药,2组均以治疗2月为1疗程,观察患儿黄疸消退、肝功能指标、胆管炎发作次数及身高、体重、生活质量情况,以评价其临床疗效。结果:黄疸消退总有效率治疗组为85%,对照组为45%,2组比较,差异有显著性意义(P<0.05)。治疗后治疗组总胆红素(TBi)l、直接胆红素(DBi)l、胆汁酸(TBA)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、γ-谷氨酰转肽酶(γ-GT)、碱性磷酸酶(ALP)较治疗前均显著下降(P<0.01),且各指标治疗后均低于对照组(P<0.05);对照组仅TBil、AST2项指标较治疗前下降(P<0.05)。胆管炎平均发作次数治疗组为1.5次/人,对照组为3.2次/人,2组比较,差异有显著性意义(P<0.05)。2组患儿身高、体重、体重指数比较,差异均无显著性意义(P>0.05)。治疗组生活质量评价优于对照组,差异有显著性意义(P<0.05)。结论:川芎嗪联合健脾化湿、温阳活血中药治疗胆道闭锁Kasai术后患儿,可加快黄疸消退,改善肝功能,减少胆管炎发作次数,提高患儿的生活质量。

Objective： To observe the clinical effect of ligustrazine and Chinese herbs in treating child- hood biliary atresia after Kasai operation. Methods： Forty patients with childhood biliary atresia after Kasai operation were equally randomized into treatment group and control group. Both groups received western routine treatment, and the treatment group were additionally given intravenous injection of ligustrazine and Chinese herbs which had the actions of strengthening spleen and removing dampness, warming yang and activating blood. Two months constituted one treatment course. After treatment for 2 courses, the im- provement of jaundice and liver function, frequency of cholangitis, body height and weight, and life qual- ity were observed for the evaluation of therapeutic effect. Results= The total effective rate for jaundice subsiding 85% in the treatment group, better than 45% in the control group（P 〈 0.05）. The liver function index including total bilirubin （TBil）, direct bilirubin （DBil）, total bile acid （TBA）, alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, gamma-glutamyl transpeptidase （γ-GT）, and alkaline phos- phatase（ALP） were decreased in the treatment group（P 〈 0.01compared with those before treatment）, and the difference of the indexes before and after treatment was lower than that in the control group（P 〈0.05）. TBil and AST were lower in the control group after treatment （P 〈 0.05 compared to those before treatment）. The cholangitis frequency in the treatment group was 1.5 times per person, lower than 3.2 times per person in the control group（P 〈 0.05）. The differences of body height, body weight and body mass index were insignificant between the two groups（P 〉 0.05）. Conclusion： Ligustrazine and Chinese herbs are effective on promoting the subsidence of jaundice, improving the liver function, reducing the cholangitis frequency, and improving the life quality of the childhood biliary atresia after Kasai operation.