赤芍承气汤对重型肝炎内毒素血症的影响

Therapeutic Efficacy of Chi-Shao-Cheng-Qi Decoction in Treating Endotoxin in Severe Hepatitis Cases

目的 :验证赤芍承气汤对重型肝炎内毒素血症的影响 ,并观察其疗效 ,探讨其作用机理 ,为临床用药提供依据。方法 :随机选择重型肝炎患者 41例 ,随机分对照组 2 0例和治疗组 2 1例。两组均给予综合治疗 ,治疗组加用赤芍承气汤 ,每日 1剂 ,共 2周。分别检测总胆红素 ( TBil)、白蛋白( Alb)、凝血酶原活动度 ( PTA)、血清内毒素 ( Endotoxin,ET)、血清肿瘤坏死因子α( TNFα)。结果 :TNFα活性与内毒素水平呈正相关 ( P<0 .0 1 ) ,治疗组 TNFα、ET水平与对照组比较有显著降低( P<0 .0 1 ) ,治疗组 TBil、PTA与对照组差异有显著性意义 ( P<0 .0 1～ 0 .0 5 ) ,Alb较对照组也有升高。治疗组好转出院率高于对照组。结论 :赤芍承气汤对重型肝炎具有显著疗效 ,其机理可能与抑制内毒素的产生与释放有关。

Objective: To observe the therapeutic efficacy of Chi Shao Cheng Qi Decoction in treating endotoxin in severe hepatitis cases.Methods:41 severe hepatits cases were divided at random into 2 groups:The treatment group (21 cases treated with comprehensive therapy and Chi Shao Cheng Qi Decoction) and the control group(treated with comprehensive therapy only). The treatment went on for 2 weeks.Detections were made on the total serum bilirubin (Tbil), albumin(Mb),prothrombin activity(PTA), endotoxin and tumor necrosis factor α(TNF α) Results:TNF α and Endotoxin (ET) levels were positively correlated to each other. ( r=0.625,P <0.01). Significance was observed in TNF α and ET levels between the treatment group and the control( P <0.01). Significance was also observed between Tbil and PTA levels between the control and treatment groups( P <0.01 to 0.05). Alb in the treatment group cases was higher than that in the control. More cases were discharged early in the treatment group than that in the control.Conclusion:Chi Shao Cheng Qi Decoction was effective in treating severe hepatitis cases with the possible mechanism of inhibiting the endotoxin.