门冬氨酸鸟氨酸联合醒脑静注射液治疗肝性脑病的疗效观察

目的:观察门冬氨酸鸟氨酸(商品名:雅博司)联合醒脑静注射液治疗肝硬化引起肝性脑病患者的临床疗效。方法:将78例肝性脑病患者随机分为治疗组(38例)和对照组(40例)。对照组采用常规综合治疗(如:解除诱因,限制饮食中蛋白含量,保持大便通畅与水、电解质平衡),静滴谷氨酸盐、谷胱甘肽等;治疗组在对照组的基础上联合门冬氨酸鸟氨酸40mL和醒脑静注射液20mL,疗程7d。观察治疗前后两组患者的临床表现,血氨和肝功能指标,评价临床疗效。结果:治疗组患者显效42.10%(16/38),有效44.74%(17/38),无效13.16%(5/38),其中死亡1例,总有效率86.84%(33/38);对照组显效30.00%(12/40),有效37.50%(15/40),无效32.50%(13/40),其中死亡4例,总有效率67.50%(27/40)。治疗组昏迷时间缩短,清醒例数增多,血氨下降明显,两组有效率比较有显著性差异(P<0.05)。结论:门冬氨酸鸟氨酸联合醒脑静注射液能有效降低血氨,治疗肝性脑病。

Effects of Ornithine-Aspartate Combined with Xingnaojing Injection on Hepatic Encephalopathy in Patients with Liver Cirrhosis

Objective： To observe the clinical efficacy of ornithine-aspartate combined with Xingnaojing injection on hepatic encephalopathy in patients with liver cirrhosis. Methods： Seventy-eight patients with liver cirrhosis and hepatic encephalopathy were randomly divided into control group and treatment group. The control group （n = 40） was treated with conventional routine, including removing causality, limiting protein in food, keeping bowel in movement, keeping water and electrolyte in balance and injecting glutathione. The treatment group （n = 38） was treated with ornithine-aspartate 40 mL and Xingnaojing injection 20 mL in addition to conventional treatment. The therapeutic course was 7 days. By observing serum ammonia and liver function of 2 groups, the clinical efficacy can be evaluated. Results： In the treatment group, 42.10 %（16/38） patients showed marked improvement of clinical syndromes, 44.74%（17/38）cases were improved, 13.16 %（5/38） cases were without any response and total efficacy rate was 86.8 %. And 1 out of 38 case died. However, in the control group, 30.00 % （12/40） patients are demonstrated to have a marked improvement, 37.50 %（15/40）patients were improved, 32.50 %（13/40）cases had no response and the total efficacy rate was 67.50 %（27/40）. And 4 out of 40 cases died. There was a significant difference in total efficacy rate between the two groups （P 〈 0.05）. The serum ammonia in the treatment group was also significantly decreased than that in the control group（P 〈 0.05）. Conclusion： Omithine-aspartate and Xingnaojing injection are effective in down-regulating serum ammonia and treating hepatic encephalopathy in patients with liver cirrhosis.