加味茵陈术附汤联合双重血浆分子吸附系统与血浆置换治疗慢加急性肝衰竭临床研究

Clinical research of Yinchen Zhufu decoction combined with dual plasma molecular adsorption system and plasma exchange in the treatment of chronic acute liver failure

目的:探讨加味茵陈术附汤联合双重血浆分子吸附系统(DPMAS)与血浆置换(PE)治疗慢加急性肝衰竭(ACLF)的临床疗效及安全性。方法:将66例ACLF患者根据治疗方案分为治疗组和对照组,每组33例。治疗组在常规治疗基础上采用中药加味茵陈术附汤联合DPMAS+PE治疗,对照组采用DPMAS+PE治疗,治疗两周,并随访8周。观察两组ACLF患者治疗后的症候积分、肝功能、凝血功能、并发症及生存率,评估加味茵陈术附汤联合DPMAS+PE治疗ACLF的临床疗效。结果:治疗组总有效率为75.75%,显著高于对照组42.42%(P<0.05);两组患者治疗后,中医症候积分、肝功能、凝血功能均较治疗前明显改善(P<0.05),且治疗组优于对照组(P<0.05)。统计两组并发症发生率,治疗组低于对照组,组间比较差异具有统计学意义(P<0.05);8周生存率比较,治疗组高于对照组,差异具有统计学意义(P<0.05)。结论:加味茵陈术附汤联合DPMAS+PE治疗ACLF,可以有效改善ACLF患者肝功能、凝血功能,并减轻临床症状,提高治疗有效率及生存率。

Objective:To discussing the clinical efficacy and safety of modified Yinchen Zhufu decoction combined with double plasma adsorption(DPMAS)and plasma exchange(PE)in the treatment of acute-on-chronic liver failure(ACLF)by collecting data before and after treatment and conduct data research and analysis.Methods:According to the treatment plan,66 ACLF patients were divided into treatment group and control group,with 33 cases in each group.The two groups were treated on the basis of conventional treatment.The treatment group was treated with Yinchen Zhufu decoction combined with DPMAS+PE,and the control group was treated with DPMAS+PE.The treatment cycle was 2 weeks,and the follow-up was 8 weeks.Medical records were collected and statistically analyzed.The clinical efficacy,syndrome score,liver function,coagulation function,complications and survival rate of ACLF patients in the treatment group and the control group were compared to evaluate the clinical efficacy of modified Yinchen Zhufu decoction combined with DPMAS+PE in the treatment of ACLF.Results:The total effective rate of the treatment group was 75.75%,which was significantly higher than that of the control group(P<0.05).After treatment,TCM syndrome score,liver function and coagulation function were significantly improved in both groups compared with before treatment(P<0.05);and the treatment group was better than the control group(P<0.05).The incidence of complications in the treatment group was lower than that in the control group,and the comparison between the two groups was statistically significant(P<0.05).The 8-week survival rate in the treatment group was significantly higher than that in the control group(P<0.05).Conclusion:Yinchen Zhufu decoction combined with DPMAS+PE in the treatment of ACLF can effectively improve the liver function and coagulation function of ACLF patients,reduce clinical symptoms,and improve the treatment efficiency and survival rate.