清热解毒、活血化瘀法治疗慢性肝功能衰竭临床观察

目的:观察清热解毒、活血化瘀法治疗慢性肝功能衰竭的临床疗效。方法:收集广西中医药大学第一附属医院2015年1月—2016年6月确诊为慢性肝功能衰竭的住院患者90例,随机分为试验组49例和对照组41例。对照组给予基础治疗、对症支持治疗及中成药护肝退黄,试验组在对照组治疗的基础上加用解毒化瘀颗粒治疗。治疗2个疗程后,记录两组患者中医证候积分情况,记录治疗第4周和第8周后肝功能包括总胆红素(total bilirubin,T-BIL)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、血清白蛋白(serum albumin,ALB)];凝血功能凝血酶原时间(blood prothrombin time,PT)、凝血酶原活动度(prothrombin activityprothrombin time activity,PTA)]的变化情况;记录腹水最深度及两组治疗后终末期肝病模型(model for end-stage liver disease,MELD)评分情况。结果:试验组治疗后TBi L、ALT、AST水平优于对照组(P0.05);试验组治疗后ALB、胆碱酯酶、MELD评分优于对照组(P0.05);试验组治疗后凝血酶原时间、腹水最深度水平、凝血酶原活动度优于对照组(P0.05);试验组有效率为81.6%,对照组有效率为53.7%,试验组明显优于对照组(P0.05)。结论:清热解毒、活血化瘀法治疗慢性肝功能衰竭疗效优于单一西医综合治疗,能显著改善患者临床症状,改善肝脏功能,降低死亡率。

Clinical Observation of the Methods of Clearing Heat and Eliminating Toxin,Activating Blood and Resolving Blood Stasis on Chronic Liver Failure

Objective:To observe the clinical effects of the methods of f clearing heat and eliminating toxin,activating blood and resolving blood stasis on chrouic liver failure.Methods:Totally 90 cases diagnosed as ehronic liver failure treated in the First Affiliated Hospital of Guangxi University of Chinese Medicine between January 2015 and June 2016 were randomized into experimental group (49 cases)and control group (41 cases).Control group were given basic treatment,symptomatic supportive treatment and Chinese patent medicine to protect the liver and removing jaundice while experimental group were added with Toxin-Eliminating and Blood-Stasis-Removing Granules.After 2 treatment courses,the TCM symptom scores were recorded.After 4 weeks and 8 weeks of treatment,the changes of liver function (including T-BIL,ALT,AST,ALB,PT and PTA)were recorded.The deepest depth of ascetic fluid and the scores of MELD in two groups were recorded.Results:The levels of T-BIL,ALT and AST and scores of ALB,T-CHE,and MELD in experimental group were superior to those in control group (P ＜ 0.05).The prothrombin time,deepest level of aseetic fluid and mobility of prothrombin in experimental group were superior to those in control group (P ＜0.05).The effective rate was 81.6％ in experimental group and 53.7％ in control group (P ＜ 0.05).Conclusion:The methods of elearing heat and eliminating toxin,activating blood and resolving blood stasis have superior therapeutic effects on chronic liver failure than simple western medicine treatment,which can significantly improve the clinical effects and liver function,and reduce the mortality of patients.