中西医结合联合灌肠疗法治疗乙型肝炎相关慢加急性肝衰竭的临床研究

发布时间：2018-03-29 17:40

本文选题：肝功能衰竭　切入点：灌肠　出处：《肝脏》2016年03期

【摘要】：目的观察中药口服联合大黄乌梅合剂高位保留灌肠结合西医常规疗法治疗乙型肝炎慢加急性肝衰竭的临床疗效。方法将50例乙型肝炎慢加急性肝衰竭患者随机分为试验组(25例)和对照组(25例),对照组给予西医常规治疗,试验组除西医常规治疗外,同时给予大黄乌梅合剂高位保留灌肠(4周)和中药辨证治疗(8周);观察临床疗效,治疗前、治疗4周、治疗8周的肝功能、凝血功能、NH3以及治疗期和随访期病毒载量的变化情况。结果试验组总有效率为52%,对照组为40%,组间疗效差异有统计学意义(P0.05)。两组治疗4周后ALT、TBil、PT、PAT差异有统计学意义(P0.05,P0.01),治疗8周后ALT、TBil、Alb、PT、PAT差异有统计学意义(P0.05,P0.01),随访48周HBV DNA阴转、病毒耐药复发两组差异有统计学意义(P0.05)。结论中西医结合联合灌肠疗法治疗乙型肝炎慢加急性肝衰竭临床疗效良好,远期HBV DNA病毒阴转率高,复发率低。
[Abstract]:Objective To observe the effect of oral Chinese medicine combined with rhubarb mixture of Fructus Mume high clinical curative effect of acute on chronic liver failure in treatment of hepatitis B combined with routine western medicine retention enema. Methods 50 cases of hepatitis B patients with acute on chronic liver failure were randomly divided into experimental group (25 cases) and control group (25 cases), the control group received conventional treatment, test in the group of conventional western medicine treatment, while giving the rhubarb mixture of Fructus Mume high retention enema (4 weeks) and medicine treatment (8 weeks); clinical observation, before treatment, 4 weeks of treatment, blood coagulation function and liver function, 8 weeks of treatment, the changes of NH3 and the treatment period and follow-up period. The results of viral load the total effective rate was 52% in the experimental group, the control group was 40%, there was significant difference between the two groups (P0.05). The two groups after 4 weeks of treatment, ALT, TBil, PT, PAT difference was statistically significant (P0.05, P0.01), after 8 weeks of treatment, ALT, TBil, Alb, PT, there was statistically significant difference PAT P0.05 (P0.01) was followed up for 48 weeks. There was a significant difference in HBV DNA negative conversion and relapse of viral resistance between the two groups (P0.05). Conclusion the combination of traditional Chinese medicine and Western medicine and enema therapy has a good clinical effect in treating chronic hepatitis B acute liver failure, and the long-term HBV DNA virus negative conversion rate is high, and the recurrence rate is low.

【作者单位】：上海市公共卫生临床中心重症肝病&ICU科;
【基金】：国家“十二五”科技重大专项(2012ZX10005-005)
【分类号】：R512.62;R575.3

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