中医多途径给药联合西医综合治疗重症肝炎的疗效分析

Efficacy analysis of multi-channel TCM delivery combined with western medicine for serious hepatitis

目的探讨中医多途径给药联合西医综合治疗重症肝炎的疗效。方法将100例重症肝炎患者按就诊顺序分为对照组和观察组各50例。对照组给予常规保肝治疗,饮食指导,静脉滴注甘草酸二铵、维生素、促肝细胞生长素及人工肝支持疗法;观察组在对照组治疗的基础上给予中医多途径给药治疗。2组均治疗2个月。观察2组患者治疗前后肝功能各项指标、内毒素、血氨、血清二胺氧化酶浓度变化情况,比较2组治疗有效率、术后并发症发生率、住院时间、人工肝治疗次数。结果观察组总有效率为82%,对照组为60%,差异有统计学意义(P<0.05);2组患者治疗前后TBIL、ALT、ALB、PTA、内毒素、血氨、尿中乳果糖和甘露醇排泄率比值、血清二胺氧化酶浓度均有所改善,观察组改善程度尤为明显(P<0.05);观察组术后并发症发生率明显低于对照组,住院时间明显短于对照组,人工肝治疗次数明显少于对照组,差异均有统计学意义(P<0.05)。结论中医多途径给药综合治疗重症肝炎疗效良好,可改善各项肝功能指标,降低并发症发生率,明显缩短住院时间,减少人工肝治疗次数,安全可行。

Objective To explore the efficacy of multi-channel TCM delivery combined with western medicine for treatment of serious hepatitis. Methods One hundred patients of serious hepatitis were divided into a treatment group and a control group according to registration order, 50 cases in each one. The control group was treated with regular liver-protection treatment, diet instruction and intravenous drip of diammonium glycyrrhizinate, vitamin, hepatocyte growth-promoting factors and artificial liver support. Based on the treatment of control group, the treatment group was treated with multi-channel TCM delivery. The treatment lasted for 2 months in both groups. The liver function index, endotoxin, blood ammonia and concentration of serum diamine oxidase before and after treatment were observed in two groups while the effective rate, occurrence rate of postoperative complications, hospital stays, the number of artificial liver treatment were compared. Results The total effective rate was 82% in the treatment group and 60% in the control group, which had statistical difference （P 〈 0. 05 ）. The TBIL, ALT, ALB, PTA, endotoxin, ammonia, urinary lactulose and mannitol excretion ratio, serum diamine oxidase concentration were all improved after the treatment in the two groups, which was more significant in the treatment group （ P 〈 0. 05 ）. The occurrence rate of postoperative complications in the observation group were significantly lower than that in the control group（P 〈 0. 05） ; the hospital stays was clearly shorter in the treatment group（ P 〈0. 05 ） ; the number of artificial liver treatment was remarkably fewer in the treatment group（P 〈 0. 05）. Conclusion The multi-channel TCM delivery comprehensive therapy has superior effects on serious hepatitis, which could improve liver function index, lower occurrence rate of postoperative complications and reduce the number of artificial liver treatment. It is safe and feasible.