解毒化瘀颗粒治疗慢加急性肝衰竭临床观察

Observation on Acute Chronic Liver Failure Treated with Jiedu Huayu Granule

目的 ：观察解毒化瘀颗粒治疗慢加急性肝衰竭的临床疗效。方法 ：将128例符合纳入标准的患者采用随机数字表方法随机分为试验组67例和对照组61例,对照组予西医综合治疗＋茵栀黄颗粒,试验组在西医综合治疗的基础上加用解毒化瘀颗粒,比较入组前组间基线特征,治疗4周为1个疗程。两组治疗2个疗程后,记录两组患者中医证候积分情况,肝功能[包括总胆红素（TBIL）、谷丙转氨酶（ALT）、谷草转氨酶（AST）、血清白蛋白（ALB）]及凝血功能[包括凝血酶原时间（PT）、凝血酶原活动度（PTA）]的变化情况;记录腹水最深度及两组治疗后终末期肝病模型（MELD）评分情况,以评价两组患者总有效率及无效率。结果 ：治疗结束后,试验组在中医证候评分情况、肝功能和凝血功能改善及腹水消退情况、终末期肝病模型（MELD）评分情况方面均优于对照组,差异有统计学意义（P〈0.05）。试验组总有效率为81.25%,对照组为71.42%;试验组并发症发生率低于对照组,安全性指标未见恶化。结论 ：解毒化瘀颗粒治疗慢加急性肝衰竭能显著改善患者临床症状,改善肝脏功能,提高生存率,降低病死率,优于单一西医综合治疗。

Objective ：To observe the Jiedu Huayu Granule treating on acute chronic liver failure. Methods ：On the base of standards 128 cases were used a random number table metho drandomly divided into experimental group 67 cases and the control group 61 cases,the control group were given Western medicine comprehensive treatment combined with Yinzhihuang Granule,the experimental group were treated by Jiedu Huayu Granule on the basis of Western medicine comprehensive treatment. Compared baseline characteristics between the former group,the period is 4 weeks. After the end of the 2 course of treatment,to record the TCM syndrome integral situation of two groups of patients,to record the change situation of the liver function T-BIL,ALT,AST,ALB and coagulation function PT,PTA;to record the most depth of ascites and the end stage liver disease model（MELD）score at fourth and eighth weeks. Evaluated the total effective rate,inefficiency rate of two groups of patients. Results ：After the end of the 2 course of treatment,the experimental group was better than the control group by TCM syndrome integral situation,the improvement of liver function,coagulation function and ascites subsided,model for end-stage liver disease（MELD）score,the difference was statistically significant（P〈0.05）. Total effective rate of the texperimental group was 81.25%,and the control group was 71.42%,the incidence of complications in the experimental group was lower than that the control group,the difference was statistically significant,safety index was not deteriorated. Conclusion ：The therapeutic effect of CLF treated by Jiedu Huayu Granule can significant improved clinical symptoms,improve the liver function,improve the survival rate,reduce mortality,better than single Western medicine comprehensive treatment.