茵陈蒿汤加减联合常规西药治疗急性黄疸型肝炎患者的效果

Effects of modified Yinchenhao decoction combined with conventional Western medicine in treatment of acute icteric hepatitis

目的:观察茵陈蒿汤加减联合常规西药治疗急性黄疸型肝炎患者的效果。方法:选取2017年12月至2020年12月该院收治的86例急性黄疸型肝炎患者进行前瞻性研究,按照随机数字表法将其分为对照组与观察组各43例。对照组采用常规西药治疗,观察组在对照组基础上联合茵陈蒿汤加减治疗,比较两组临床疗效、治疗前后中医证候积分、肝功能指标[总胆红素(TBIL)、直接胆红素(DBIL)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)]水平和不良反应发生率。结果:观察组治疗总有效率为93.02%(40/43),高于对照组的74.42%(32/43),差异有统计学意义(P<0.05);治疗后,两组便溏不爽、脘闷腹胀、身目俱黄等中医证候积分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组TBIL、DBIL、AST、ALT水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:茵陈蒿汤加减联合常规西药治疗急性黄疸型肝炎患者可提高治疗总有效率,降低中医证候积分和肝功能指标水平,效果优于单纯常规西药治疗。

Objective:To observe effects of modified Yinchenhao decoction combined with conventional Western medicine in treatment of acute icteric hepatitis.Methods:A prospective study was conducted on 86 patients with acute icteric hepatitis admitted to the hospital from December 2017 to December 2020.They were divided into control group and observation group according to the random number table method,43 cases in each.The control group was treated with conventional Western medicine,while the observation group was treated with Yinchenhao decoction on the basis of that of the control group.The clinical efficacy,the TCM syndrome scores before and after the treatment,the liver function index levels[total bilirubin(TBIL),direct bilirubin(DBIL),aspartate aminotransferase(AST),alanine aminotransferase(ALT)],and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of treatment in the observation group was 93.02%(40/43),which was higher than 74.42%(32/43)in the control group,and the difference was statistically significant(P<0.05).After the treatment,the TCM scores such as loose stools,abdominal distension,and yellow eyes and skin in the two groups were lower than those before the treatment,those of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).The levels of TBIL,DBIL,AST and ALT in the two groups were lower than those before the treatment,those of observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Modified Yinchenhao decoction combined with conventional western medicine can improve the total effective rate of treatment and reduce the TCM scores and the liver function index levels in the patients with acute icteric hepatitis.Moreover,it is superior to single conventional western medicine treatment.