解毒化瘀颗粒治疗乙型肝炎病毒相关慢加急性肝衰竭的疗效评价

Efficacy evaluation of Jiedu Huayu Granules in the treatment of hepatitis B virusassociated subacute liver failure

目的:回顾性分析解毒化瘀颗粒治疗乙型肝炎病毒(HBV)相关慢加急性肝衰竭(HBV-ACLF)临床疗效。方法:回顾分析2016年1月至2021年12月住院治疗的179例HBV-ACLF患者临床资料,其西医综合治疗患者80例(对照组),在西医综合治疗基础上加用解毒化瘀颗粒治疗的患者99例(观察组),采用MELD和COSSH-ALCF评分系统评估解毒化瘀颗粒对HBV-ACLF患者治疗效果。结果:治疗8周后,观察组患者的总体有效率高于对照组(78.8%vs 55.0%,P<0.05);肝功能及凝血功能指标改善程度明显优于对照组(P<0.01);同时,观察组患者肝性脑病和腹膜炎发生率低于对照组(37.3%vs 47.5%,P<0.05);8周内观察组患者病死率较对照组明显降低(8.08%vs 21.25%,P<0.05)。两组患者治疗8周后MELD和COSSH-ALCF评分均较入院时降低,且观察组患者降低幅度大于对照组(P<0.05)。结论:在西医综合治疗的基础上加用解毒化瘀颗粒口服治疗可提高HBV-ACLF患者临床疗效,值得进一步验证。

Objective:To investigate the clinical efficacy and prognosis of Jiedu Huayu granule in the treatment of HBV-ACLF.Methods:The clinical data of 179 patients with HBV-ACLF hospitalized from January 2016 to December 2021 were retrospectively analyzed.Among them,80 patients(control group)received comprehensive treatment of Western medicine,and 99 patients(observation group)received Jiedu Huayu Granule on the basis of control group.MELD and COSSH-ALCF scores were used to evaluate the regulatory effect of Jiedu Huayu granules on the prognosis of HBV-ACLF patients.Results:The overall effective rate of observation group was significantly higher than that of group A(78.8%vs 55.0%,P<0.05).The improvement of liver function and coagulation function was better than that of control group(P<0.01).The incidence of hepatic encephalopathy and peritonitis was significantly decreased(37.3%vs 47.5%,P<0.05).The mortality within 8 weeks in observation group was significantly lower than that in control group A(8.08%vs 21.25%,P<0.05).MELD and COSSH-ALCF scores in both groups were lower after treatment than on admission,and the decrease range in group A+B was greater than that in group A,the difference was statistically significant(P<0.05).Conclusion:Jiedu Huayu granule oral treatment on the basis of comprehensive treatment in Western medicine can improve the clinical efficacy of HBV-ACLF,and its improvement effect on the prognosis of HBV-ACLF was verified by MELD and COSSH-ALCF scoring model,which is worthy of further verification and promotion.