大黄合剂联合雅博司对早期肝性脑病临床疗效及血氨、内毒素影响

Effect of Rhubarb Mixture Combined with Hepa Merz on the Clinical Effect and Blood Ammonia,Endotoxin of Early Hepatic Encephalopathy

目的:探讨大黄合剂联合雅博司对早期肝性脑病临床疗效及血氨、内毒素的影响。方法:选取我院肝胆内科收治的早期肝性脑病患者166例,按随机数字表法分组,对照组83例予以常规治疗联合门冬氨酸鸟氨酸治疗,研究组83例在对照组基础上予以大黄合剂保留灌肠治疗,观察并记录两组间肝功能和血氨指标、血清内毒素及炎症因子水平、血清神经损伤相关指标水平、神志清醒时间及认知功能,同时对比临床疗效。结果:对照组治疗有效率(74.69%)低于研究组治疗有效率(87.95%),具有统计学意义(P<0.05);与对照组比较,研究组治疗后血清ALT、AST、TBIL、NH3水平较低,治疗后血清LPS、TNF-α、IL-18、IL-6水平较低,治疗后血清β-EP、S100B、NSE水平较低,治疗后神志清醒时间较短,MMSE评分、HDS-R评分较高,具有统计学意义(P<0.05)。结论:大黄合剂联合门冬氨酸鸟氨酸治疗能够有效降低早期肝性脑病患者血氨、内毒素、炎症因子及血清β-EP、S100B、NSE水平,改善肝功能,减轻炎症反应及神经损伤,缩短患者神志清醒时间,提高认知功能,临床疗效确切。

Objective：To investigate the clinical effect of Rhubarb Mixture combined with Hepa Merz on the clinical effect and blood ammonia、endotoxin of early hepatic encephalopathy. Methods：166 patients with early hepatic encephalopathy from the department of hepatobiliary in our hospital were selected and divided into 2 groups,83 cases in the control group received conventional treatment combined with L-ornithine-L-aspartate,83 cases in the experiment group received Rhubarb Mixture retention enema treatment on the basis of the control group,liver function and blood ammonia index,levels of serum endotoxin and inflammatory factors,serum levels of nerve injury related index,recovery time of consciousness awakening and cognitive function,and the clinical effect were compared after the treatment. Results：The effective rate in the control group（74.69%）was lower than the experiment group（87.95%）,with significant difference（P〈0.05）;compared with the control group,serum levels of ALT,AST,TBIL,NH_3 were lower after treatment in the experiment group,serum levels of LPS,TNF-α,IL-18,IL-6 were lower after treatment,serum levels of β-EP,S100 B,NSE were lower after treatment,the recovery time of consciousness awakening was shorter and the MMSE score,HDS-R score were higher after treatment,with significant difference（P〈0.05）. Conclusion：Rhubarb Mixture combined with L-ornithine-L-aspartate can effectively reduce levels of blood ammonia,endotoxin,inflammatory factors and serum β-EP,S100 B,NSE levels in patients with early hepatic encephalopathy,improve liver function,reduce inflammatory reaction and nerve injury,shorten the recovery time of consciousness awakening,improve cognitive function,the clinical curative effect was exactly.