促醒汤保留灌肠联合西药治疗肝性脑病

目的观察促醒汤保留灌肠联合西药治疗肝性脑病的临床效果。方法病例来源于2012年1月-2016年12月在我院就诊的肝性脑病患者82例,随机分为观察组与对照组,各41例。2组均采用降低血氨生成,祛除诱因,降低血氨,保护肝脏,禁止蛋白质摄入、出现脑水肿者采用甘露醇脱水、补充人血白蛋白、血浆和支链氨基酸,抗感染等常规治疗。对照组采用西药治疗,静脉滴注醒脑静以及门冬氨酸鸟氨酸;观察组联合使用促醒汤,间隔12 h,早晚灌肠治疗。2组均治疗1周。比较2组临床治疗效果,扑翼样震颤消失时间及苏醒时间,治疗前、治疗后3 d、5 d、7 d血氨水平变化。结果观察组总有效率92.68%,高于对照组的75.61%(P0.05);观察组扑翼样震颤消失时间以及苏醒时间均明显短于对照组(P0.05);与治疗前相比较,2组治疗后3 d、5 d、7 d患者血氨水平均明显降低(P0.05),且观察组优于对照组(P0.05)。结论促醒汤保留灌肠联合西药治疗肝性脑病,可有效促进血氨排出,加快恢复苏醒,安全有效。

Awaking decoction retention enema combined with western medicine in the treatment of hepatic encephalopathy

Objective To investigate the clinical effect of retention enema combined with western medicine in treatment of hepatic encephalopathy.Methods Selected 82 cases of patients with hepatic encephalopathy who were treated in our hospital from January 2012 to December 2016, divided into two groups randomly, 41 cases in observation group, 41 cases in control group.Two groups of patients were treated with lower blood ammonia generation, elimination of incentives, reduces the blood ammonia, liver protection, prohibit protein intake, plasma complement and branched chain amino acids.The control group was treated with western medicine, intravenous Xingnaojing and L-ornithine-L-aspartate; The observation group used a combination of Awaking decoction, 12h interval.The clinical effects of the two groups were compared. The disappearance time and the recovery time of the flapping wing tremor in the two groups were observed, and the blood ammonia levels of 3 d, 5 d, 7 d in the two groups before and after treatment were compared.Results After treatment, the effective rate of the observation group was 90.24％, significantly higher than that of the control group 75.61％ (P<0.05); The disappearance time and the recovery time of the flapping wing tremor in the observation group were significantly shorter than those in the control group (P<0.05); The average level of serum ammonia in the two groups was significantly higher than that before treatment (P<0.05), and the observation group was significantly higher than that of the control group (P<0.05). Conclusion Awaking decoction retention enema combined with western medicine clinical effect in the treatment of hepatic encephalopathy is better than pure western medicine treatment, can effectively promote the discharge of blood in patients with hepatic encephalopathy ammonia, accelerate the recovery of clear, safe and effective, it has high value in clinical application.