退黄合剂治疗湿热瘀阻型肝细胞性黄疸临床观察报告

Clinical observation on treating the Shire Yuzu type of hepatocellular jaundice with the Tuihuang mixture

目的:观察利湿化瘀方药退黄合剂治疗湿热瘀阻型肝细胞性黄疸的临床疗效以及对患者肝脏炎症指标(ALT、AST、GGT)、胆红素代谢指标(TBIL、DBIL、DBIL/TBIL)、凝血功能的检测结果和中医症状、体征的改善作用。方法:60例患者随机分为两组,治疗组34例,对照组26例,两组均按统一诊断标准纳入病例,两组患者的性别、年龄、病程经统计学处理,差异无显著性(P>0.05),具有可比性。两组均于治疗前1周开始直至疗程结束停用其他影响疗效判定的中药和西药,治疗组用退黄合剂口服,30m L/次,3次/d;对照组用茵栀黄颗粒,2袋/次,3次/d。疗程:两组均以4周为一个疗程。主要疗效指标:血清总胆红素(TBIL)及综合退黄效果评价。次要疗效指标:其他肝功能指标及中医证候评分。安全性指标:治疗前后血常规、尿常规、大便常规和肾功能测定及心电图检查。并观察记录药物不良反应。结果:治疗组和对照组的总有效率分别为88.24%(30/34)和76.92%(20/26),两组的愈显率分别为67.65%(23/34)和23.08%(6/26),其中治疗组黄疸症状明显改善,肝脏炎症指标ALT(P<0.05)、AST(P<0.05)、GGT(P<0.05)以及胆红素代谢指标TBIL(P<0.01)、DBIL(P<0.01)、DBIL/TBIL(P<0.05)均有明显改善。治疗组和对照组均能有效改善肝脏炎症指标和胆红素代谢指标,但治疗组更为明显,治疗组总有效率和愈显率显著高于对照组。结论:退黄合剂对湿热瘀阻型肝细胞性黄疸有显著疗效,而且对肝脏炎症指标(ALT、AST、GGT)、胆红素代谢指标(TBIL、DBIL、DBIL/TBIL)、凝血功能等实验室指标也有明显改善作用,提示利湿化瘀法具有有效保护肝脏和降低黄疸,改善症状等作用。

Objective: In this study, clinical effects of the removing dampness and blood stasis prescription on the moist heat and blood stasis hepatocellular jaundice were observed. The liver inflammatory indicators (ALT, AST, GGT), bilirubin metabolism indicators (TBIL, DBIL, DBIL/TBIL), blood coagulation function and the improvement of TCM symptom and physical sign were observed. Methods:60 patients were randomly divided into two groups. The treatment group took the Tuihuang mixture (30mL, tid, po), and the control group took the Yinzhihuang granules(6g, tid, po), for 4 weeks. Results: Total efficiency in the treatment group and control group were 88.24% (30/34) and 76.92% (20/26), and the obvious curative rate were 67.65% (23/34) and 23.08% (6/26). Jaundice symptoms in the treatment group, liver inflammatory indicators ALT, AST, GGT and bilirubin metabolism indicators TBIL, DBIL, DBIL/TBILwere all significantly improved (P<0.05), and those in the treatment group was more significantly obviously. Conclusion: This study suggested that the Tuihuang mixture not only get well curative effects on the moist heat and blood stasis hepatocellular jaundice, but also significantly improved liver inflammatory indicators (ALT, AST, GGT), bilirubin metabolism indicators (TBIL, DBIL, DBIL/TBIL) and blood coagulation function.This study showed that removing dampness and blood stasis prescription was effective on liver protection, jaundice and could improve clinical symptoms.