清热解毒凉血法治疗乙肝相关性肝衰竭的临床经验总结

Summary of clinical experience of detoxify cooling method in treatment of HBV related liver failure

目的探讨分析并总结应用清热解毒凉血法治疗乙肝相关性肝衰竭的临床经验。方法选取2014年2月-2015年6月我院收治的热毒炽盛型乙肝病毒相关性慢加急性肝衰竭早期患者64例,随机分为中西医治疗组30例,西医治疗组34例。西医治疗组仅给予西医内科综合治疗,中西医治疗组在西医内科综合治疗的基础上加用清热解毒凉血法中药口服及保留灌肠,观察两组治疗后第1个月和第2个月的肝功能指标、凝血酶原活度（PTA）,及两组治疗总有效率。结果中西医结合组同一时间点与西药治疗组比较,ALT、AST、Alb比较差异无统计学意义（P〉0.05）;TBil、CHE、PTA比较,差异有统计学意义（P〈0.05）。中西医治疗组总有效率明显高于西医治疗组,差异有统计学意义（P〈0.05）。结论清热解毒凉血法能有效阻止乙肝病毒相关性慢加急性肝衰竭疾病从早期进展到中期,同时能够降低严重并发症的发生率,值得临床推广应用。

Objective To explore and summarize the clinical experience of detoxify cooling method in treatment of HBV related liver failure. Methods 64 cases of patients with reduchishen type hepatitis B virus of acute on chronic liver failure in early stage cured in our hospital from February 2014 to June 2015 were selected and randomly divided into integrated traditional Chinese and western medicine treatment group with 30 cases and western medicine treatment group with 34 cases.Patients in western medicine treatment group were treated with comprehensive therapy of western medicine alone,and patients in integrated traditional Chinese and western medicine treatment group were treated with detoxify cooling method of oral medicine and retention enema on the basis of comprehensive therapy of western medicine.Liver function indexes after first months and second months after treatment,prothrombin activity（PTA）,and total effective rate of the two groups were observed. Results Comparison of the same time point between integrated traditional Chinese and western medicine treatment group and western medicine treatment group showed that there were no statistical significance on the comparison of LT,AST,Alb（P〉0.05）,and there were some statistical significances on the comparison of TBil,CHE,PTA（P〈0.05）.The total effective rate of integrated traditional Chinese and western medicine treatment group was significantly higher than that of western medicine treatment group with statistical significance,（P〈0.05）. Conclusion Detoxify cooling method can effectively prevent the hepatitis B virus associated with acute liver failure from early to mid. At the same time,it can reduce the incidence of serious complications.It is worthy of clinical popularization and application.