中药保留灌肠治疗肝硬化内毒素血症的疗效观察

Retention enema therapy with traditional Chinese medicine for patients with liver cirrhosis related endotoxemia

目的:观察中药自拟方保留灌肠治疗肝硬化内毒素血症的临床疗效。方法:选择100例肝硬化内毒素血症住院患者,随机分为观察组与对照组各50例。观察组患者给予中药复方(水煎剂)保留灌肠,隔日1次,连续14 d;对照组不给予中药治疗。在第15 d对比两组患者的血清内毒素(ET)、总胆红素(TBil)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、血氨(NH3)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)水平;比较内毒素血症治疗结果、症状积分变化及并发症等。结果:完成随访91例。治疗后观察组患者的ET水平低于对照组(P<0.05),观察组患者TBil、NH3、IL-6水平低于对照组(P<0.05),ALT、AST两组无统计学差异(P>0.05)。观察组患者痊愈及治疗有效的病例数多于对照组,组间差异具有统计学意义(P<0.05)。观察组患者在发热、腹胀、胁痛3个方面的症状改善程度优于对照组(P<0.05)。两组患者在并发症的差异无统计学意义(P>0.05)。结论:自拟方中药保留灌肠治疗肝硬化内毒素血症的疗效肯定,且有助于改善患者临床症状,安全性良好。

Objective:To investigate the clinical effect of retention enema therapy with traditional Chinese medicine for the treatment of liver cirrhosis related endotoxemia.Methods:One hundred patients with liver cirrhosis related endotoxemia(67 males and 33 females,aged 37~75 years)were randomly divided into observation group and control group.The observation group was given retention enema therapy with a traditional Chinese medicine compound(water decoction),once every other day for 14 days,while the control group was not treated with traditional Chinese medicine.On the 14th day,serum level of endotoxin(ET),total bilirubin(TBil),alanine aminotransferase(ALT),aspartate aminotransferase(AST),blood ammonia(NH3),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-10(IL-10)were compared between the two groups.Outcomes of endotoxemia treatment,symptom score changes,and complications were also compared.Results:A total of 91 cases were followed up.After treatment,the level of ET in the observation group was lower than that of the control group(P<0.05).The levels of TBil,NH3,and IL-6 in the observation group were lower than those in the control group(P<0.05),but there was no statistical difference with regard to the ALT and AST(P>0.05).The number of cases effectively treated in the observation group was more than that in the control group,and the difference between the groups was statistically significant(P<0.05).The improvement of symptoms in the observation group was better than that in the control group(P<0.05).There was no significant difference in complications between the two groups(P>0.05).Conclusion:The effect of retention enema therapy with traditional Chinese medicine for the treatment of liver cirrhosis related endotoxemia is of promising potential,and it can improve the clinical symptoms of patients and has good safety.