前列腺素E1联合血浆置换治疗慢性重型肝炎的临床研究

Objective To investigate the curative effect, timing and feasibility of prostaglandin E1 combined plasma exchange in treatment of chronic severe hepatitis. Methods Eighty-eight patients with chronic severe hepatitis were randomly divided into treatment group and control group. The treatment group was given prostaglandin E1 combined plasma exchange treatment based on the comprehensive treatment of internal medicine. Control group only had given the internal medicine comprehensive treatment. Results The symptoms and signs of the treatment group were improved after treatments, especially with total bilirubin, cholinesterase, prothrombin activity, NH3 ( P ＜ 0.01,P ＜ 0.05 ). After treatment, except for albumin, the others indicators of the two groups had significant difference ( P ＜ 0.05). Follow-up for three months, the total effective rate of the treatment group was 69.6% ( 32cases ), early effective rate was 79.3% (23 cases), mid-term effective rate was 64.3% (9 cases) were all significantly higher than those of control group [47.6% (20 cases), 55.6% ( 15 cases), 38.5% (5 cases)] (P ＜ 0. 01 ).Conclusion Prostaglandin E1 combined with plasma exchange in treatment of chronic severe hepatitis can improve the liver function and survival rate significantly.     

前列腺素E1联合血浆置换治疗慢性重型肝炎的临床研究

Objective To investigate the curative effect, timing and feasibility of prostaglandin E1 combined plasma exchange in treatment of chronic severe hepatitis. Methods Eighty-eight patients with chronic severe hepatitis were randomly divided into treatment group and control group. The treatment group was given prostaglandin E1 combined plasma exchange treatment based on the comprehensive treatment of internal medicine. Control group only had given the internal medicine comprehensive treatment. Results The symptoms and signs of the treatment group were improved after treatments, especially with total bilirubin, cholinesterase, prothrombin activity, NH3 ( P ＜ 0.01,P ＜ 0.05 ). After treatment, except for albumin, the others indicators of the two groups had significant difference ( P ＜ 0.05). Follow-up for three months, the total effective rate of the treatment group was 69.6% ( 32cases ), early effective rate was 79.3% (23 cases), mid-term effective rate was 64.3% (9 cases) were all significantly higher than those of control group [47.6% (20 cases), 55.6% ( 15 cases), 38.5% (5 cases)] (P ＜ 0. 01 ).Conclusion Prostaglandin E1 combined with plasma exchange in treatment of chronic severe hepatitis can improve the liver function and survival rate significantly.     

前列腺素E1联合血浆置换治疗慢性重型肝炎的临床研究

目的 探讨前列腺素E1联合血浆置换治疗慢性重型肝炎的疗效.方法 将88例慢性重型肝炎患者完全随机分为治疗组与对照组.治疗组46例,在内科综合治疗的基础上予前列腺素E1联合血浆置换治疗;对照组42例,只予内科综合治疗.观察2组治疗前后的症状体征及相关实验室指标.结果 治疗组经治疗后症状体征均明显好转,总胆红素、ALT、总蛋白、白蛋白、胆碱酯酶、凝血酶原活动度、血氨均改善明显(P＜0.01或P＜0.05).治疗后,2组间除白蛋白水平外,其余各指标均差异有统计学意义(P＜0.05).随访3个月,治疗组总有效率69.6%(32例)、早期有效率79.3%(23例)、中期有效率64.3%(9例),均明显高于对照组的47.6%(20例)、55.6%(15例)、38.5%(5例),差异均有统计学意义(均P＜0.01).结论 前列腺素E1联合血浆置换治疗慢性重型肝炎能明显改善肝功能,明显提高疗效.

Abstract：

Objective To investigate the curative effect, timing and feasibility of prostaglandin E1 combined plasma exchange in treatment of chronic severe hepatitis. Methods Eighty-eight patients with chronic severe hepatitis were randomly divided into treatment group and control group. The treatment group was given prostaglandin E1 combined plasma exchange treatment based on the comprehensive treatment of internal medicine. Control group only had given the internal medicine comprehensive treatment. Results The symptoms and signs of the treatment group were improved after treatments, especially with total bilirubin, cholinesterase, prothrombin activity, NH3 ( P ＜ 0.01,P ＜ 0.05 ). After treatment, except for albumin, the others indicators of the two groups had significant difference ( P ＜ 0.05). Follow-up for three months, the total effective rate of the treatment group was 69.6% ( 32cases ), early effective rate was 79.3% (23 cases), mid-term effective rate was 64.3% (9 cases) were all significantly higher than those of control group [47.6% (20 cases), 55.6% ( 15 cases), 38.5% (5 cases)] (P ＜ 0. 01 ).Conclusion Prostaglandin E1 combined with plasma exchange in treatment of chronic severe hepatitis can improve the liver function and survival rate significantly.     

无创正压通气在老年慢性阻塞性肺疾病急性加重期患者中的应用效果分析

Objective To study the clinical effect of non-invasive positive pressure ventilation (NPPV) in elderly patients with acute exacerbation of chronic obstructive pulmonary diseases (AECOPD). Methods One hundred and Fourteen elderly patients with AECOPD were divided into two groups. The observed group of 58 patients was given oxygen, anti-inflammatory and other conventional treatment, at the same time NPPV treatment was given, But the control group of 56 cases was only given the conventional treatment. The difference of blood oxygen pressure ( PaO2 ), carbon dioxide partial pressure ( PaCO2 ), pH value, respiratory rate (RR) and heart rate (HR)between two groups were compared after 12 h. To compare two groups endotracheal intubation rate and mortality differences. Results The pH and PaO2 of the observation group were significantly higher than that before treatment , HR, RR and PaCO2 decreased significantly compared with before treatment, and the various indicators were better than the same period in the control group. The observation group endotracheal intubation rate and mortality were less than the control group ( all P ＜ 0. 05). Conclusions NPPV can effectively alleviate breathing difficulties of the elderly patients with AECOPD and correct hypoxia. NPPV can reduce the rate of endotracheal intubation and mortality.     

无创正压通气在老年慢性阻塞性肺疾病急性加重期患者中的应用效果分析

Objective To study the clinical effect of non-invasive positive pressure ventilation (NPPV) in elderly patients with acute exacerbation of chronic obstructive pulmonary diseases (AECOPD). Methods One hundred and Fourteen elderly patients with AECOPD were divided into two groups. The observed group of 58 patients was given oxygen, anti-inflammatory and other conventional treatment, at the same time NPPV treatment was given, But the control group of 56 cases was only given the conventional treatment. The difference of blood oxygen pressure ( PaO2 ), carbon dioxide partial pressure ( PaCO2 ), pH value, respiratory rate (RR) and heart rate (HR)between two groups were compared after 12 h. To compare two groups endotracheal intubation rate and mortality differences. Results The pH and PaO2 of the observation group were significantly higher than that before treatment , HR, RR and PaCO2 decreased significantly compared with before treatment, and the various indicators were better than the same period in the control group. The observation group endotracheal intubation rate and mortality were less than the control group ( all P ＜ 0. 05). Conclusions NPPV can effectively alleviate breathing difficulties of the elderly patients with AECOPD and correct hypoxia. NPPV can reduce the rate of endotracheal intubation and mortality.     

阿德福韦酯联合大黄廑虫丸治疗乙型病毒性肝炎失代偿期肝硬化疗效观察

Objective To observe the efficacy of combined adefovir dipivoxil and Rhubarb Zhechong pill for treatment of hepatitis B decompensated cirrhosis. Methods Sixty-one cases of hepatitis B decompensated cir-rhosis patients were randomly divided into two groups. The treatment group was treated with adefovir dipivoxil and rhubarb Zhechong pill, plus conventional medical treatment. All treatments were continued for one year. Symptoms, liver function, hepatic fibrosis changes and the HBV-DNA negative rate before and after treatment were observed. Results The efficiency rate in treatment group was 93.5%, higher than that in control group (80. 0%) (P < O. 05). ALT,TBIL,HA, LN ,PC Ⅲ in treatment group were significantly lower (P < 0.01 or P < 0.05) after them-py. Meanwhile the decrease of ALT, HA, LN, PC Ⅲ after therapy were higher than that in control group (P < 0.01 or P <0.05). The HBV-DNA negative rate in treatment group was 87.9%, higher than that of control group(13.5%) (P < 0. 01). Conclusion Combined Adefovir dipivoxil and rhubarb Zhechong pill can improve the prognosis in hepatitis B decompensated cirrhosis patients.     

阿德福韦酯联合大黄廑虫丸治疗乙型病毒性肝炎失代偿期肝硬化疗效观察

Objective To observe the efficacy of combined adefovir dipivoxil and Rhubarb Zhechong pill for treatment of hepatitis B decompensated cirrhosis. Methods Sixty-one cases of hepatitis B decompensated cir-rhosis patients were randomly divided into two groups. The treatment group was treated with adefovir dipivoxil and rhubarb Zhechong pill, plus conventional medical treatment. All treatments were continued for one year. Symptoms, liver function, hepatic fibrosis changes and the HBV-DNA negative rate before and after treatment were observed. Results The efficiency rate in treatment group was 93.5%, higher than that in control group (80. 0%) (P < O. 05). ALT,TBIL,HA, LN ,PC Ⅲ in treatment group were significantly lower (P < 0.01 or P < 0.05) after them-py. Meanwhile the decrease of ALT, HA, LN, PC Ⅲ after therapy were higher than that in control group (P < 0.01 or P <0.05). The HBV-DNA negative rate in treatment group was 87.9%, higher than that of control group(13.5%) (P < 0. 01). Conclusion Combined Adefovir dipivoxil and rhubarb Zhechong pill can improve the prognosis in hepatitis B decompensated cirrhosis patients.     

阿德福韦酯联合大黄廑虫丸治疗乙型病毒性肝炎失代偿期肝硬化疗效观察

Objective To observe the efficacy of combined adefovir dipivoxil and Rhubarb Zhechong pill for treatment of hepatitis B decompensated cirrhosis. Methods Sixty-one cases of hepatitis B decompensated cir-rhosis patients were randomly divided into two groups. The treatment group was treated with adefovir dipivoxil and rhubarb Zhechong pill, plus conventional medical treatment. All treatments were continued for one year. Symptoms, liver function, hepatic fibrosis changes and the HBV-DNA negative rate before and after treatment were observed. Results The efficiency rate in treatment group was 93.5%, higher than that in control group (80. 0%) (P < O. 05). ALT,TBIL,HA, LN ,PC Ⅲ in treatment group were significantly lower (P < 0.01 or P < 0.05) after them-py. Meanwhile the decrease of ALT, HA, LN, PC Ⅲ after therapy were higher than that in control group (P < 0.01 or P <0.05). The HBV-DNA negative rate in treatment group was 87.9%, higher than that of control group(13.5%) (P < 0. 01). Conclusion Combined Adefovir dipivoxil and rhubarb Zhechong pill can improve the prognosis in hepatitis B decompensated cirrhosis patients.     

阿德福韦酯联合大黄廑虫丸治疗乙型病毒性肝炎失代偿期肝硬化疗效观察

Objective To observe the efficacy of combined adefovir dipivoxil and Rhubarb Zhechong pill for treatment of hepatitis B decompensated cirrhosis. Methods Sixty-one cases of hepatitis B decompensated cir-rhosis patients were randomly divided into two groups. The treatment group was treated with adefovir dipivoxil and rhubarb Zhechong pill, plus conventional medical treatment. All treatments were continued for one year. Symptoms, liver function, hepatic fibrosis changes and the HBV-DNA negative rate before and after treatment were observed. Results The efficiency rate in treatment group was 93.5%, higher than that in control group (80. 0%) (P < O. 05). ALT,TBIL,HA, LN ,PC Ⅲ in treatment group were significantly lower (P < 0.01 or P < 0.05) after them-py. Meanwhile the decrease of ALT, HA, LN, PC Ⅲ after therapy were higher than that in control group (P < 0.01 or P <0.05). The HBV-DNA negative rate in treatment group was 87.9%, higher than that of control group(13.5%) (P < 0. 01). Conclusion Combined Adefovir dipivoxil and rhubarb Zhechong pill can improve the prognosis in hepatitis B decompensated cirrhosis patients.     

血脂康胶囊对慢性心力衰竭患者心功能及C反应蛋白的影响

Objective To investigate the effect of Xuezhikang capsule on chronic heart failure (CHF) and C-reactive protein (CRP). Methods Forty-eight patients were randomly divided into two groups. Control group (22 cases) had angiotensin-converting enzyme inhibitor β-blockers, diuretics and digitalis preparations treatment. Based on the same treatment of the control group, patients in Xuezhikang group (26 cases) were given extra Xuezhi-kang capsule 0.6g, twice a day. Echocardiography was taken to the two groups, and CRP level was tested by en-zyme-linked immunoabserbent assay. Results After treatment, the total effective rate of Xuezhikang group (88. 5%) was higher than that of control group (68.2%). CRP in Xuezhikang group(2.87±1.34) mg/L was decreased after treatment (P < 0.05). After treatment, the heart function of both group were significantly improved, especially in Xuezhikang group. Conclusion Xuezhikang capsule improves the heart function and reduces serum CRP level in chronic heart failure patients.     

谷胱甘肽对慢性乙型肝炎的疗效分析

目的:观察还原型谷胱甘肽对慢性乙型肝炎的疗效。方法:选择慢性乙型肝炎60例,按随机表分组,治疗组和对照组各30例。对照组采用一般的护肝治疗,治疗组在一般治疗基础上加用还原型谷胱甘肽,每日1次,每次1 200m g,静脉滴注,4周为一疗程,分别于治疗前、治疗后2周、治疗后4周观察患者临床症状、体征并测定肝功能指标。结果:治疗组肝功能恢复明显较对照组快(P<0.05)。临床显效率为36.7%,总有效率为86.7%。结论:还原型谷胱甘肽对慢性乙型肝炎患者肝功能的恢复、改善临床症状有重要意义。     

异甘草酸镁联合恩替卡韦治疗早期慢性重症乙型肝炎的疗效观察

目的 观察异甘草酸镁联合恩替卡韦治疗早期慢性重症乙型肝炎的疗效.方法 将54例慢性重症乙型肝炎患者完全随机分为观察组(29例)和对照组(25例).2组在内科常规治疗的基础上,观察组另接受异甘草酸镁( 150 mg/d)和恩替卡韦(0.5 mg/d)治疗,观察2组肝功能指标及乙型肝炎病毒(HBV)DNA的变化.结果 治疗后2组血清总胆红素(TBil)、ALT、AST、血清白蛋白(ALB)、凝血酶原时间(PT)等肝功能指标均明显下降,与治疗前比较差异具有统计学意义(P＜0.05).治疗后观察组TBil及HBV DNA水平明显低于对照组,差异具有统计学意义[(70±26)μmol/L比(95±21) μmol/L,HBV DNA阴转率于2、4、6周分别为24.1％(7)比0％(0)、75.9％( 22)比0％(0)、82.8％(24)比4.0％(1),P＜0.05];ALT、AST、ALB及PT的组间差异无统计学意义[(101±19) U/L比(94±17) U/L、(75±17) U/L比(78±17) U/L、(38±3)g/L比(38 ±4) g/L、( 14 ±4)s比(15 ±5)s,P＞0.05].结论 异甘草酸镁联合恩替卡韦治疗慢性重症乙型肝炎有较好的疗效和安全性.     

水飞蓟宾磷脂酰胆碱复合物治疗慢性乙型肝炎的疗效观察

目的:观察水飞蓟宾磷脂酰胆碱复合物治疗肝功能异常的慢性乙型肝炎的疗效和安全性.方法:选取80例肝功能异常的慢性乙肝患者,随机分成试验组和对照组各40例.试验组口服水飞蓟宾磷脂酰胆碱复合物,每次120 mg,tid,共12周,对照组口服护肝宁片每次4片,tid,疗程12周;对两组疗效进行比较,评价治疗前后患者临床症状和肝功能与肝纤维化指标的恢复情况,同时记录不良反应.结果:治疗后,试验组和对照组病人的症状均有不同程度改善,其中试验组有乏力和腹胀病人的症状改善率明显高于对照组(P＜0.05).两组患者治疗后的肝功能及血清纤维化指标与治疗前比较均得到显著改善,但两组间比较差异无统计学意义(P＞0.05).试验组总有效率达75%,对照组为70%,两组比较差异无统计学意义(P＞0.05).且都无明显的不良反应.结论:水飞蓟宾磷脂酰胆碱复合物治疗肝功能异常的慢性乙肝患者安全、有效.     

慢性乙型肝炎合并甲状腺功能亢进症48例分析

目的 探讨慢性乙型肝炎合并甲状腺功能亢进症的临床特征及治疗效果.方法 选择201 1年8月至2014年12月在本院就诊的48例慢性乙型肝炎合并甲状腺功能亢进症患者,均抗乙肝病毒及护肝治疗,根据是否选择抗甲状腺功能亢进症治疗分为抗甲状腺功能亢进症组31例和不抗甲状腺功能亢进症治疗的对照组17例,分析慢性乙型肝炎合并甲状腺功能亢进症者的临床特征,观察两组治疗后肝功能、甲状腺功能改善情况.结果 抗甲状腺功能亢进症组住院天数小于对照组(P＜0.05);慢性乙型肝炎合并甲状腺功能亢进症者以女性为主(68.75％);而两组性别、年龄、居住地差异无统计学意义(P＞0.05);治疗1月后两组ALT、AST、TBil、DBil均下降(P＜0.05);抗甲状腺功能亢进症组治疗后ALT、AST、TBil、DBil高于对照组(P＜0.05),肝功能改善程度不及对照组;抗甲状腺功能亢进症组治疗后Fr3、Fr4降低(P＜0.05),且低于对照组(P＜0.05),TSH升高(P＜0.05),且高于对照组(P＜0.05).结论 慢性乙型肝炎合并甲状腺功能亢进症患者在抗乙肝病毒及护肝治疗的同时可选择抗甲状腺功能亢进症治疗,可同时改善肝功能及甲状腺功能.     

拉米夫定治疗慢性乙型肝炎疗效观察

目的观察拉米夫定治疗慢性乙型肝炎疗效及不良反应。方法将慢性乙型肝炎患者121例随机分成观察组69例和对照组52例,观察组给予拉米夫定100mg,口服,1次／日。对照组给予a-2b干扰素300万IU,肌注,1次／日。两周后改为隔日1次。两组均辅以维生素族及一般护肝药,治疗期间不加用其他抗病毒药物。经治疗一年后,观察两组的临床疗效（观察两组血清A坍复常率、HBeAg转阴率及血清HBV—DNA阴转率）及不良反应。对照组与治疗组的复常率及阴转率进行zz检验。结果治疗一年,观察组血清ALT复发率为91．30％（63／69）;HBeAg阴转率为52．17％（36／69）;血清HBV—DNA阴转率为86．96％（60／69）。对照组血清AIJrr复常率为42．31％（22／52）;HBeAg阴转率为30．77％（16／52）;HBV—DNA阴转率为48．08％（25／52）,比较差异均有显著性（Jp〈0．05）。且拉米夫定的副作用低于a-2b干扰素。结论拉米夫定是治疗慢性乙型肝炎安全有效药物,连续用药1年,肝功能复常、病毒转阴及血清学转换显著,均优于干扰素,值得临床推广。     

六味五灵片联合复方甘草酸苷治疗活动性慢性乙型肝炎肝硬化的疗效观察

目的探讨六味五灵片联合复方甘草酸苷治疗活动性慢性乙型肝炎肝硬化的临床疗效。方法选取2015年2月—2016年2月在驻马店市中心医院接受治疗的78例活动性慢性乙型肝炎肝硬化患者为研究对象,根据治疗方案的差别分为对照组(39例)和治疗组(39例)。对照组患者口服复方甘草酸苷片,75 mg/次,3次/d。治疗组在对照组的基础上口服六味五灵片,1.5 g/次,3次/d。两组患者均经过48周治疗。评价两组患者临床疗效,同时比较治疗前后两组患者HBV-DNA和乙型肝炎E抗原(HBe Ag)转阴率、肝功能、肝纤维化指标以及肝硬度和Child-Pugh评分。结果治疗后,对照组和治疗组的总有效率分别为79.49%和94.87%,两组比较差异具有统计学意义(P0.05)。治疗24、48周后,治疗组中HBV-DNA和HBe Ag转阴率均分别高于同期对照组患者,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者肝功能血清丙氨酸氨基转移酶(ALT)、门冬氨酸转氨酶(AST)、总胆红素(TBIL)均显著降低,白蛋白(ALB)明显升高,同组比较差异具有统计学意义(P0.05);且治疗组患者肝功能显著优于对照组(P0.05)。治疗后,两组患者血清透明质酸(HA)、层黏连蛋白(LN)、Ⅲ型前胶原肽(PC-Ⅲ)、Ⅳ型胶原(Ⅳ-C)均明显降低(P0.05);且治疗组上述肝纤维化指标显著低于对照组患者(P0.05)。治疗后,两组患者肝硬度和Child-Pugh评分均明显降低(P0.05);且治疗组患者肝硬度和Child-Pugh评分明显低于对照组患者(P0.05)。结论六味五灵片联合复方甘草酸苷治疗活动性慢性乙型肝炎肝硬化可有效改善患者肝功能和肝纤维化指标,具有一定的临床推广应用价值。     

多烯磷脂酰胆碱治疗慢性乙型肝炎合并脂肪肝损害临床疗效观察

目的：观察多烯磷脂酰胆碱治疗慢性乙型肝炎合并脂肪肝损害的临床疗效。方法：选择确诊慢性乙型肝炎合并脂肪肝损害63例;随机分为两组。治疗组（n=33）在常规保肝治疗的基础上,加服多烯磷脂酰胆碱胶囊,456mg/次,每日3次;对照组（n=30）常规保肝治疗;两组均4周为1个疗程。结果：两种药物临床总有效率分别为93.9%、66.7%,血清胆红素下降及肝功能恢复治疗组较对照组明显（P〈0.05）。结论：多烯磷脂酰胆碱治疗慢性乙型肝炎合并脂肪肝损害,能取得较为满意的疗效,未见明显副作用。     

门冬氨酸鸟氨酸治疗乙型肝炎肝硬化临床疗效观察

目的观察门冬氨酸鸟氨酸治疗乙型肝炎肝硬化患者的疗效。方法 82例乙型肝炎肝硬化患者随机分为治疗组和对照组各41例,2组患者均接受常规治疗,治疗组用注射用门冬氨酸鸟氨酸10 g,加入液体中静脉滴注,每日1次。对照组用注射用还原型谷胱甘肽1.2 g,加入液体中静脉点滴,每日1次,共治疗4周。结果治疗组在症状改善及肝功复常方面明显优于对照组（P〈0.05）。结论门冬氨酸鸟氨酸可广泛用于治疗乙型肝炎肝硬化,疗效确切,应用安全。     

促肝细胞生长素肠溶胶囊治疗慢性乙型病毒性肝炎72例疗效观察

目的观察促肝细胞生长素肠溶胶囊治疗慢性乙型病毒性肝炎的疗效。方法144例患者随机分为两组,72例常规治疗加促肝细胞生长素肠溶胶囊作为试验组,每日服2粒,每日3次,疗程12周;另72例常规治疗加促肝细胞生长素颗粒剂作为对照组,每次2袋,每日3次,疗程12周。服药前及服药时4、8、12周及治疗结束后4、8、12周测定肝功能、症状与体征变化。结果两组治疗后肝功能的多项指标均有明显改善,且治疗结束后12周肝功能尚持续改善;临床症状和体征也有明显改善,治疗组总有效率达76.57%。结论促肝细胞生长素肠溶胶囊能有效改善慢性乙型病毒性肝炎患者症状、体征与肝功能,且未见明显不良反应,使用安全。