清热化湿、凉血解毒法治疗乙型肝炎慢加急性肝衰竭临床观察

Clinical observation of clearing heat and removing dampness, cooling blood and detoxicating therapy for acute on chronic liver failure in hepatitis B

目的观察清热化湿、凉血解毒法治疗乙型肝炎慢加急性肝衰竭的疗效。方法将72例乙型肝炎慢加急性肝衰竭患者分为治疗组和对照组,对照组采用西医综合治疗,治疗组在此基础上加用清热化湿、凉血解毒中药治疗,以8周为1个疗程观察2组疗效。结果治疗组在第1周末症状积分改善优于对照组(P<0.01);在第4周末终末期肝病模型(MELD)分值低于对照组、凝血酶原活动度(PTA)高于对照组,差异有统计学意义(P<0.05),TBIL水平低于对照组,但差异无统计学意义(P>0.05);治疗8周末治疗组和对照组的病死率分别为11.8%和15.8%,差异无统计学意义(P>0.05)。结论清热化湿、凉血解毒中药可以改善慢加急性肝衰竭患者早期的临床症状,并在改善患者凝血功能和促进胆红素消退方面有一定的效果。

Objective To observe the efficacy of clearing heat and removing dampness, cooling blood and detoxicating therapy for acute on chronic liver failure in hepatitis B. Methods Seventy-two cases of acute on chronic liver failure were divided into a treatment group and a control group. The comprehensive treatment of western medicine was applied in the control group, on basis of which Chinese medicine of clearing heat and removing dampness, cooling blood and detoxicating was applied in the treatment group. The efficacy of two groups was observed with eight weeks as a treatment course. Results The impl^ovement of symptom score in the treatment group was superior to that in the control group at the end of one week （P 〈 0.01）. At the end of four weeks, the MELD score in the treatment group was lower and PTA wa~ higher than those in the control group, which had statistical differences （P 〈 0.05）. The level of TBIL in the treatment group was lower than that in the control group, which had no statistical difference （P 〉 0.05）. The fatality rate at the end of eight weeks was 11.8% in the treatment group and 15.8% in the control group respectively, which had no statistical difference （P 〉 0.05）. Conclusion The Chinese medicine of clearing heat and removing dampness, cooling blood and detoxicating could improve clinical symptoms of acute on chronic liver failure at early stage; also it has positive effect on promoting coagulation fimction and bilirubin fading.