通腑开窍法治疗TIPS术后肝性脑病的临床疗效

目的:回顾性分析中医通腑开窍法治疗TIPS术后肝性脑病对比非TIPS术后肝性脑病的治疗情况,分析疗效。方法:采用回顾性分析方法收集2017年1月1日—2019年5月1日符合肝硬化失代偿期行经颈静脉肝内门体静脉分流(TIPS)术后并存在肝性脑病且联合中医通腑开窍法治疗的20例患者,通腑开窍法方药以大承气汤加菖蒲、郁金等,采用口服或者灌肠;分别统计分析治疗后第1天、第3天、1周的血氨恢复、肝性脑病疗效。结果:联合中医通腑开窍法治疗TIPS术后肝性脑病与非TIPS术后血氨恢复、肝性脑病恢复时间第1天有显著差异(P<0.05),第3天、1周后无显著差别(P>0.05)。结论:中医通腑开窍法对经颈静脉肝内门体静脉分流(TIPS)术后肝性脑病对比非TIPS术后肝性脑病第1天较差,第3天开始总体疗效相当。

Clinical effect of Hepatic encephalopathy after TIPS treated by tongfu kaiqiao method

Objective:Through retrospective analysis of the treatment of hepatic encephalopathy after TIPS by traditional Chinese medicine Tongfu kaiqiao method,and analysis of the curative effect.Methods:A retrospective analysis was conducted to collect 20 patients with hepatic encephalopathy who underwent transjugular intrahepatic portosystemic shunt(TIPS)from January 1,2017 to May 1,2019 during the decompensated period of cirrhosis,and they were treated with the method of traditional Chinese medicine Tongfu kaiqiao method,Dachengqi decoction with calamus,tulip and so on of Tongfu kaiqiao method,Oral or enema,The recovery of blood ammonia and the therapeutic effect of hepatic encephalopathy on the first day,the third day and the first week after treatment were statistically analyzed.Results:There were significant differences in the recovery time of serum ammonia and hepatic encephalopathy between patients with hepatic encephalopathy after TIPS and those without TIPS treated by TCM Tongfu Kaiqiao method on the first day(P<0.05).There was no significant difference after 3 days and 1 week(P>0.05).Conclusion:TCM Tongfu kaiqiao method is worse in patients with hepatic encephalopathy after TIPS than in patients with hepatic encephalopathy after non-TIPS on the first day,and the overall effect is comparable from the third day.