茵陈四苓汤口服联合大剂量丹参注射液治疗重型肝炎38例临床疗效观察

A clinical observation on oral administration of YinChenSiLingTang combined with large doses of Danshen injection for treatment of patients with severe hepatitis

目的观察茵陈四苓汤口服联合大剂量丹参注射液治疗重型肝炎的临床疗效。方法选择住院治疗的重型肝炎患者38例,按随机原则分为治疗组(18例)和对照组(20例)。对照组给予常规内科保肝、对症及血浆置换(PE)治疗;治疗组在对照组治疗基础上给茵陈四苓汤水煎服,每天1剂。两周为1疗程,同时给予丹参注射液80ml每日2次静脉滴注;两组疗程均为28d。观察治疗后患者临床症状、体征的改善情况;取血测定血常规、肝功能、凝血功能的变化。结果治疗28d后,治疗组病死率明显低于对照组(P<0.01);脘腹胀满、倦怠乏力、口苦症状的比例明显低于对照组(P<0.05)。两组治疗后白细胞计数(WBC)、红细胞计数(RBC)、血红蛋白(Hb)、血氨、总胆红素(TBil)均降低,凝血酶原活动度(PTA)升高;且治疗组与对照组治疗后WBC、RBC、TBil、、PTA PLT比较差异有统计学意义(P<0.05)。结论茵陈四苓汤口服联合大剂量丹参注射液可明显改善重型肝炎的高胆红素血症,缩短病程,降低病死率。

Objective to observe the clinical therapeutic effect of oral administration of YinChenSiLingTang combined with large doses of Danshen injection for treatment of patients with severe hepatitis.Methods 38 patients with severe hepatitis hospitalized the hospital of Integrated Chinese and Western Medicine of Dazhou Sichuan Dazhou were randomly divided into treatment group(18 cases)and control group(20 cases).The patients in control group were treated with conventional medical treatment and Plasma exchange.(PE),while the patients in treatment group were treated with YinChenSiLingTang 1 times per day combined with large doses of Danshen injection 80ml intravenous infusion twice daily on the basis of treat ment in the control group.the therapeutic course was 28 days in both groups,The changes of clinical symptoms and Blood routine,liver function,blood coagulation function in both groups were observed after 28 days of treatment.Results:The mortality in treatment group was significantly lower than that in the control group after 28 days of follow-up(P<0.01),the degrees of abdominal distention fatigue,mouth bitterness improved obviously compared with those in the control group(P<0.05).The white blood cell count(WBC),red blood cell count(RBC),hemoglobin(Hb),blood ammonia,TBIL in the two groups were markedly decreased and prothrombin activity(PTA)in creased after treatmen,there were statistical significant differences in WBC、RBC、TBiL 、PTA 、PLT bet ween the two groups(P<0.05).Conclusion:Oral dministration of YinChenSiLingTang combined with large doses of Danshen injection is an effective proposal which can improve the hypercholesterolemia,reduce the course of the illness and decrease mortality in patients with severe hepatitis.