大黄制剂联合门冬氨酸鸟氨酸治疗肝性脑病的临床研究

Clinical study of Rhubarb Decoctio n combined with Ornithine aspartate for injection in treatiment of Hepatic Encephalopathy

目的:评价大黄制剂灌肠联合门冬氨酸鸟氨酸治疗肝性脑病的效果。方法:将58例肝性脑病患者随机分为A(18例)、B(20例)、C(20例)三组,A组予常规治疗,B组在常规治疗基础上用门冬氨酸鸟氨酸,C组在常规治疗基础上联合使用大黄制剂灌肠。监测三组患者清醒所需时间、血氨、谷丙转氨酶、总胆红素降低值,并评价临床疗效。结果:A、B、C三组总有效率存在显著统计学差异(P<0.01),其中C组治疗效果最好,三组有效率分别为90%、75%、50%。三组患者治疗至清醒所需时间、血NH3降低值、ALT降低值及TBIL降低值比较有统计学差异(P值均<0.01),其中C组清醒所需时间最短[平均为(14.1±3.8)h],血NH3、ALT和TBIL较治疗前降低最为明显[分别为(43.8±7.1)umol/L、(67.2±10.5)U/L和(70.9±11.1)μmol/L]。结论:大黄制剂灌肠联合门冬氨酸鸟氨酸治疗肝性脑病可缩短昏迷时间,降低血氨、改善肝功能,最终提高疗效,无明显不良反应。

Objective：To evaluate the efficacy of Rhubarb Decoction combine Ornithine Aspartate for injection to treating Hepatic Encephalopathy. Method：58 patients with hepatic encephalopathy were randomly divided into group A（n=18）、B（n=20） and C （n=20）. Patients in group A were treated with only routine means;Patients in group B were treated with routine means and Aspartate omithine;Patients in group C were treated with Rhubarb Decoction and that was at the same of group B. Monitoring the time to awake 、changes in liver function and clinical effects. Results：There was statistically significant difference in clinical efficacy（P0.01）、in the time from beginning of treatment to revival、in decreasing value of blood ammonia、ALT and TBIL （P0.01）. The overall effective rate of group A,B and C was in turn 90%, 75% and 50%. Awaking timeof group C[（14.1 ±3.8） hours]was shorter than group A[（21.0±3.4） hours]and group B[（17.5±4.4）hours].Decreasing value of blood ammonia、ALT and TBIL in group C[（43.8±7.1）μmol/L、（67.2±10.5）U/ L、（70.9 ±11.1）μmol/L]was more than group A and B. Conclusion：Treating hepatic encephalopathy by the rhubarb enema combined with Ornithine aspartate can shorten the duration of coma,reduce the blood ammonia values、ALT values and TBIL values and ultimately improve the efficacy;There is no significant adverse reactions.