中药口服加高位保留灌肠结合西药治疗乙型肝炎肝衰竭临床研究

目的观察中药口服联合大黄乌梅合剂高位保留灌肠结合西医常规疗法治疗乙型肝炎肝衰竭的临床疗效。方法将50例乙型肝炎肝衰竭患者随机分为试验组和对照组各25例,对照组给予西医常规治疗,试验组除西医常规治疗外,同时给予大黄乌梅合剂高位保留灌肠（3-4周）和中药辨证治疗（7-8周）;观察临床疗效及治疗前、治疗4周和治疗8周肝功能、凝血功能和高迁移率族蛋白B1（HMGB1）的变化情况。结果试验组总有效率为44.0%,对照组为28.0%,组间疗效差异有统计学意义（P〈0.05）。两组治疗4周后ALT、ALB、PT、PAT和HMGB1差异有统计学意义（P〈0.05,P〈0.01）,治疗8周后ALT、TB IL、PT、PAT和HMGB1差异有统计学意义（P〈0.05,P〈0.01）。结论中药口服加高位保留灌肠结合西医常规疗法治疗乙型肝炎肝衰竭临床疗效良好。

Clinical study on herbal oral administration,high-retention enema plus westen medicine in treating hepatic failure due to hepatitis B

Objective To observe the clinical effects of herbal oral administration,high-retention enema plus westen medicine in treating hepatic failure due to hepatitis B.Methods Fifty cases of liver failure due to chronic hepatitis B were randomly divided into two groups,with 25 cases in each group.The control group was given conventional western treatment;and the treatment group,in addition to the same therapy as the control group,was given 3-4 weeks of high retention enema of ＂Dahuang Wumei Mixture＂,and oral 7-8weeks of Chinese herbal medicine.Liver function index,blood coagulation and high mobility group box 1（HMGB1） were observed before treatment and 4-week,8-week after treatment.Results The total effective rate in the treatment group was 44.0%,and was 28.0% in the control group,with no significant difference between the two groups（P〈0.05）.Compared with the control group,the levels of ALT and ALB in the treatment group were significantly improved after four weeks（P〈0.01） and the levels of ALT and TBIL were lowered after eight weeks（P〈0.05,P〈0.01）,with significant differences in the contents of PT,PAT and HMGB1 between the two groups both after four and eight weeks（P〈0.05,P〈0.01）.Conclusion Combined treatment of Chinese herbal oral administration,high-retention enema plus westen medicine has good effect on liver failure due to chronic hepatitis B.