活血化痰解毒汤联合还原性谷胱甘肽治疗湿热瘀毒型重症肝炎随机平行对照研究

Huoxue Huatan Jietu Decoction(活血化痰解毒汤) combined with Glutathione in Treatment of Damp Heat and Toxin Type of Severe Hepatitis Randomized Controlled Study

[目的]]观察活血化痰解毒汤联合还原性谷胱甘肽治疗湿热瘀毒型重症肝炎疗效。[方法]使用随机平行对照方法,将132例住院患者按病志号抽签方法简单随机分为两组。对照组66例抗病毒,葡醛内酯,促肝细胞生成素、维生素C等,还原型谷胱甘肽1.2g+0.9%氯化钠100m L,静滴,1次/d。治疗组66例活血化痰解毒汤(茵陈、金钱草各30g,鸡内金、桃仁、赤芍、丹参各20g,大黄10g,栀子、蒲公英各15g,生甘草3g),水煎300m L,1剂/d,3次/d;西药治疗同对照组。连续治疗1个月为1疗程。观测临床症状、谷丙转氨酶(ALT)、谷草转氨酶(AST)、胆碱酯酶(CHE)、总胆红素(TB)、直接胆红素(DB)、凝血酶原时间(PT)、白蛋白(Aib)、不良反应。连续治疗2疗程,随访3个月,判定疗效。[结果]ALT、AST两组均有改善(P<0.01),治疗组改善优于对照组(P<0.05),CHE两组均无明显变化(P>0.05);总胆红素(TB)、直接胆红素(DB)治疗组均明显改善(P<0.01),对照组无明显变化(P>0.05);PT治疗组均明显改善(P<0.01),对照组无明显变化(P>0.05);Aib两组均有改善(P<0.01,P<0.05),治疗组改善优于对照组(P<0.01)。[结论]活血化痰解毒汤联合还原性谷胱甘肽治疗湿热瘀毒型重症肝炎,疗效满意,无严重不良反应,值得推广。

[Objective] To observe the therapeutic effect of Huoxue Huatan Jiedu decoction combined with reduced glutathione in the treatment of damp heat Stasis Toxin Type of severe hepatitis. [Method] Using random parallel control method, 132 cases of hospitalized patients according to disease will draw simple method, were randomly divided into two groups. The control group of 66 cases of antiviral, D-glueuronolactone, pI-IGF, vitamin C, glutathione 1.2g＋0.9% sodium chloride lO0mL, intravenous drip, 1 times/d. Treatment group （n=66） Huatan Huoxue Jiedu Decoction （capillaries, Lysimachia christinae each 30g, Gallus gallus domesticus, peach kernel, radix paeoniae rubra, radix salviae mihiorrhizae, 20g, rhubarb lOg, gardenia, dandelion each 15g, licorice 3G）, decoction 300ml, daily 1 agent, 3 times/D; western medicine in the treatment of with the control group. Continuous treatment for 1 months for the 1 course of treatment. Observation of clinical symptoms, alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, cholinesterase （CHE）, total bilirubin （TB）, direct bilirubin （DB）, prothrombin time （PT）, albumin （ALB）, adverse reactions. Continuous 2 courses of treatment, follow-up of 3 months, the curative effect. [Results] ALT, AST two groups had improvement （P〈0.01）. Treatment group was better than that of the control group （P〈0.05）, CHE in the two groups showed no significant change （P 〉0.05）; total bilirubin （TBIL）, direct bilirubin （DB） in the treatment group were significantly improved （P〈0.01）, the control group had no significant change （P〉0.05）; Pt treatment group were improved significantly （P〈0.01）, the control group had no significant change （P〉0.05）; ALB in both groups had improve （P〈0.01, P〈0.05）, treatment group was better than control group （P〈0.01）. [Conclusion] huoxuehuatan decoction combined with glntathione in treatment of damp heat and toxin type of severe hepatitis, satisfactory curative effect, no serious adverse reactions, worthy of promotion.