健脾活血解毒汤对肝硬化患者腹胀情况及肠黏膜通透性的影响

Effect of Jianpi Huoxue Jiedu Decoction(健脾活血解毒汤)on Abdominal Distension and Intestinal Mucosa Permeability in Patients with Liver Cirrhosis

目的:观察健脾活血解毒汤对肝硬化患者腹胀积分及肠黏膜通透性指标的影响,为临床治疗提供依据。方法:将60例肝硬化腹胀患者按照随机数字表法分为对照组和治疗组,每组30例。两组均予肝硬化常规治疗,在此基础上对照组加服双歧杆菌三联活菌肠溶胶囊,治疗组加服健脾活血解毒汤,2周为1个疗程,均连续治疗2个疗程。治疗前及治疗2周末、4周末分别评定两组腹胀积分;测定两组患者肠黏膜通透性指标血清总胆红素(TBil)、总胆汁酸(TBA)、内毒素水平,门静脉内径及血流速度,肝功能Child-Pugh分级;随访2个月观察两组并发症发生率。结果:治疗2周末,两组患者腹胀积分均较治疗前下降(P<0.05);治疗4周末,两组患者腹胀积分,肠黏膜通透性指标血清TBil、TBA、内毒素及门静脉血流速度、肝功能Child-Pugh分级,均较治疗前改善(P<0.05),且治疗组效果优于对照组(P<0.05);随访2个月,对照组出现腹水加重3例、肝性脑病1例、肠道感染2例,治疗组出现腹水加重1例,治疗组并发症发生率(3.3%)低于对照组(20.0%)(P<0.05)。结论:健脾活血解毒汤可改善肝硬化患者腹胀及肠黏膜通透性,且有利于降低患者近期并发症发生率。

Objective:To observe the effect of Jianpi Huoxue Jiedu Decoction(健脾活血解毒汤)on abd-ominal distension and intestinal mucosa permeability in patients with liver cirrhosis.Methods:A total of 60 patients with cirrhosis and abdominal distension were divided into the control group and treatment group according to random number table,30 patients in each group.On the basis of conventional treatment,the control group was treated with bifidobacterium trigeminal enteric dissolving capsules,while the treatment group was treated with Jianpi Huoxue Jiedu Decoction,2 weeks as 1 course,continued for 2 courses.Before treatment and at the end of the second and the fourth weeks of treatment,the abdominal distension scores of the two groups were assessed,and the serum total bilirubin(TBil),total bile acid(TBA),endotoxin level,portal vein diameter and blood flow velocity,Child-Pugh classification of liver function of the two groups were measured.Follow-up lasted for 2 months to observe the incidence of complications in both groups.Results:After 2 weeks of treatment,the abdominal distension scores of the two groups were lower than those before treatment(P<0.05).At the 4th week of treatment,the abdominal distension scores,intestinal permeability indicators:serum TBil,TBA,endotoxin,and blood flow velocity of portal vein,Child-Pugh classification,all improved compared with those before treatment(P<0.05),and the treatment group was better than the control group(P<0.05).After 2 months of follow-up,3 cases of ascites worsened,1 case of hepatic encephalopathy,2 cases of intestinal infection(20.0%)in the control group,1 case of ascites worsened in the treatment group(3.3%).The incidence of complications in the treatment group was lower than that in the control group(P<0.05).Conclusion:Jianpi Huoxue Jiedu Decoction can improve abdominal distension and intestinal mucosal permeability in patients with liver cirrhosis,and is beneficial to reduce the incidence of recent complications.