通腑开窍法对TIPS术后肝性脑病患者疗效观察

Observation on treating hepatic encephalopathy after TIPS bythe Tongfu Kaiqiao therapy

目的:探讨利用中医通腑开窍法治疗经颈静脉肝内门体静脉分流(Transjugular Intrahepatic portal systemic shunt,TIPS)术后肝性脑病(Hepatic Encephalopathy,HE)患者疗效,及对患者生活质量的影响。方法:采用随机分组对照方法,拟对2017年1月1日2018年11月1日符合肝硬化失代偿期行TIPS术后20名肝性脑病患者随机分为单纯西医治疗组及联合中医治疗组(予以通腑开窍法方药以大承气汤加菖蒲、郁金等,方式采用口服或者灌肠);治疗分别观察或随访记录两组患者治疗后第1天、第3天、1周的肝功能[谷丙转氨酶(Alanine aminotransferase,ALT)、谷草转氨酶(Aspartate aminotransferase,AST)、总胆红素(Total Bilirubin,TBIL)]、血氨(Blood Ammonia,BA)、肝性脑病发生率。结果:联合中医治疗组较单纯西医治疗组血氨升高、肝性脑病的发生率明显下降,肝功能改善方面两组基本相当。结论:中医通腑开窍法对TIPS术后肝性脑病患者的有一定治疗作用,可以改善TIPS术后患者生活质量。

Objective:To explore the curative effect of the Tongfu Kaiqiao therapy(通腑开窍法)on hepatic encephalopathy after TIPS,and its impact on the quality of life.Methods:According to randomized grouping control method,20 patients were randomly divided into the simple western medicine group and combined TCM medicine group.The incidence of hepatic function,BA and hepatic encephalopathy were observed and recorded on the first day,the third day and the first week after treatment.Results:The BA was elevated;incidence of hepatic encephalopathy was significantly lower in the combined TCM medicine group than the western medicine group.The improvement of liver function in the two groups was basically the same.Conclusion:The Tongfu Kaiqiao therapy shows a certain therapeutic effect on hepatic encephalopathy after TIPS,and can improve the quality of life after TIPS.