六味醒神颗粒治疗肝硬化轻微型肝性脑病的临床疗效及其对血氨和内毒素的影响

Clinical Effects of LiuweiXingshen Granules in Treating Mild Hepatic Encephalopathy of Liver Cirrhosis and Its Influence on Blood Ammonia and Endotoxin

目的:观察六味醒神颗粒治疗肝硬化轻微型肝性脑病(minimal hepatic encephalopathy,MHE)的临床疗效及其对血氨、内毒素的影响。方法:将肝硬化MHE患者52例按照随机数字表法分为两组各26例。对照组予常规支持治疗,治疗组在对照组基础上加用六味醒神颗粒。治疗2周后统计临床疗效,检测两组治疗前后肝功能[谷丙转氨酶(alanine transaminase,ALT)、总胆红素(total bilirubin,TBIL)]、血氨及内毒素水平,计算数字连接试验A(number connection test,NCT-A)、数字符号试验(digital symbol test,DST)评分。结果:治疗2周后两组患者肝功能(ALT、TBIL)、血氨及内毒素水平较治疗前降低,差异有统计学意义(P<0.05),且治疗组低于对照组(P<0.05)。治疗后两组患者NCT-A时间均较治疗前缩短(P<0.05),且治疗组短于对照组(P<0.05)。治疗后两组患者DST评分均较治疗前升高(P<0.05),且治疗组高于对照组(P<0.05)。治疗组总有效率为92.3%(24/26),高于对照组的76.0%(19/25)(P<0.05)。结论:六味醒神颗粒能降低肝硬化MHE患者血氨、内毒素水平,能提高患者集中注意能力、精神运动反应速度、精神运动的准确性等,进而改善患者认知功能。

Objective:To observe clinical effects of Liuwei Xingshen granules in the treatment of MHE of liver cirrhosis and its influence on blood ammonia and endotoxin.Methods:All 52 MHE patients were allocated to two groups in light of random number table method,26 cases in each group.The control group accepted conventional supportive treatment,the treatment group took Liuwei Xingshen granules based on conventional supportive treatment,after two weeks of treatment,to analyze clinical effects,to detect the levels of liver function(ALT and TBIL),plasma ammonia and endotoxin before and after treating in two groups,to calculate the scores of NCT-A and DST.Results:After two weeks of treatment,the levels of liver function(ALT and TBIL),plasma ammonia and endotoxin in both groups were lower than these before treating,and the difference was statistically significant(P<0.05),and the treatment group was lower than the control group(P<0.05).After treating,NCT-A time of both groups reduced compared with that before treating(P<0.05).and the treatment group was less than the control group(P<0.05).After treating,DST scores of both groups rose than these before treating(P<0.05),and the treatment group was higher than the control group(P<0.05).Total effective rate of the treatment group was 92.3%(24/26),higher than 76.0%(19/25)of the control group(P<0.05).Conclusion:Liuwei Xingshen granules could reduce the levels of plasma ammonia and endotoxin,raise cognitive flexibility,the patients’ability of focusing their attention,psychomotor reaction speed,psychomotor accuracy and others,thus improve their cognitive function.