牛黄清瘟饮对乙型肝炎慢加急性肝衰竭患者胆汁淤积及肝纤维化的作用研究

Effect of Niuhuang Qingwen Decoction on Cholestasis and Hepatic Fibrosis in the Treatment of Chronic and Acute Liver Failure of Hepatitis B

目的观察牛黄清瘟饮治疗乙型肝炎慢加急性肝衰竭所致胆汁淤积及肝纤维化的疗效。方法采用随机数字表法将乙型肝炎慢加急性肝衰竭患者随机分为观察组、犀角组、西药组,各组均给予常规西药治疗,犀角组加予犀角散口服,观察组加予牛黄清瘟饮,疗程3周;比较各组治疗前后血清总胆红素(TBIL)、血清胆汁酸(TBA)、谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)、FibroScan值、Ⅲ型前胶原(PCⅢ)等肝脏相关指标的改善情况。结果各组治疗后TBIL、TBA、GGT、ALP、FibroScan值、PCⅢ指标均明显改善(P<0.05),观察组改善情况均优于西药组及犀角组(P<0.05);观察组总有效率明显高于西药组及犀角组(P<0.05);各组在治疗期间均未发生严重的不良反应。结论牛黄清瘟饮能有效改善乙型肝炎慢加急性肝衰竭患者的肝功能及纤维化,缓解胆汁淤积的症状,提高患者的生活质量。

Objective:To observe the effect of Niuhuang Qingwen Decoction on cholestasis and hepatic fibrosis caused by chronic and acute liver failure of hepatitis B.Methods:Patients who met with the inclusion criteria were randomly divided into the observation group,Xijiao group and the western medicine group.The three groups were all treated with conventional western medicine,the Niuhuang Qingwen Decoction group was added with Niuhuang Qingwen Decoction,and the Xijiao group was added with Xijiao Powder.All patients were treated for 3 weeks.Improvement of liver-related indicators,such as serum total bilirubin(TBIL),serum bile acid(TBA),glutamyl transpeptidase(GGT),alkaline phosphatase(ALP),FibroScan value,typeⅢprocollagen(PCⅢ)before and after treatment in each group were compared.Results:After treatment,TBIL,TBA,GGT,ALP,FibroScan,and PCⅢindicators were significantly improved in each group(P<0.05).The improvement of the observation group was better than that of the western medicine group and Xijiao group(P<0.05);the total effective rate of the observation group was obviously,it was higher than the western medicine group and Xijiao Powder group(P<0.05);no serious adverse reactions occurred in each group during the treatment period.Conclusion:Niuhuang Qingwen Decoction can effectively improve the liver function and fibrosis of patients with chronic and acute liver failure of hepatitis B,relieve the symptoms of cholestasis,and improve the quality of life of patients.