解毒利湿化瘀方联合中药灌肠治疗乙型肝炎病毒相关慢加急性肝衰竭临床观察

Clinical Observation on Jiedu Lishi Huayu Recipe Combined with Chinese Medicine Enema in the Treatment of Chronic Acute Liver Failure Related to Hepatitis B Virus

目的探讨解毒利湿化瘀方联合中药灌肠治疗乙型肝炎病毒相关慢加急性肝衰竭的临床效果。方法选择江西省定南县人民医院消化内科2018年8月—2020年10月收治的71例乙型肝炎病毒相关慢加急性肝衰竭患者作为研究对象,根据患者就诊顺序将其分为对照组(36例)和观察组(35例),对照组采用常规西药治疗,观察组在对照组基础上增加解毒利湿化瘀方联合中药灌肠进行治疗,比较2组患者的临床疗效及治疗前后中医证候积分和肝功能变化情况。结果观察组治疗总有效率97.14%(34/35)高于对照组的80.56%(29/36),2组间比较,差异具有统计学意义(P<0.05)。治疗后观察组中医证候积分低于对照组,丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、直接胆红素(DBIL)水平显著低于对照组(P<0.05)。2组白蛋白(ALB)水平比较,差异无统计学意义(P>0.05)。结论解毒利湿化瘀方联合中药灌肠治疗乙肝病毒相关慢加急性肝衰竭可提高治疗效果,降低患者中医证候积分,改善患者肝功能。

Objective To explore the clinical effect of Jiedu Lishi Huayu recipe combined with Chinese medicine enema in the treatment of chronic hepatitis B virus-related acute liver failure.Methods 71 patients with chronic hepatitis B virus-related chronic and acute liver failure who were admitted to the Department of Gastroenterology in People’s Hospital of Dingnan County from August 2018 to October 2020 were selected as the research subjects,and they were divided into control group of 36 cases and the observation group of 35 cases according to the order of visits.The control group was treated with conventional western medicine,and the observation group was treated with Jiedu Lishi Huayu recipe combined with Chinese medicine enema on the basis of the control group.The clinical efficacy,traditional Chinese medicine(TCM)syndrome scores and liver function changes of the two groups were compared before and after treatment.Results The total effective rate of the observation group was 97.14%(34/35),which was higher than that of the control group(80.56%,29/36),and the difference between the two groups was statistically significant(P<0.05).After treatment,TCM syndrome score of observation group was lower than control group,alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),direct bilirubin(DBIL)levels were significantly lower than control group(P<0.05).There was no significant difference in albumin(ALB)level between 2 groups(P>0.05).Conclusion Jiedu Lishi Huayu recipe combined with Chinese medicine enema in the treatment of chronic hepatitis B virus-related acute liver failure can improve the therapeutic effect,reduce the patient’s TCM syndrome score,and improve the patient’s liver function.