摘要
目的观察解毒凉血健脾方治疗乙型肝炎慢加急性肝衰竭高风险肝胆湿热、毒邪蕴结证患者的疗效。方法前瞻性搜集80例乙型肝炎慢加急性肝衰竭高风险肝胆湿热、毒邪蕴结证患者,应用SAS 9.2软件PROC PLAN程序制定随机方案,产生随机分配方案的序列,随机序号和分组方案采用不透光的密封信封隐藏,随机分为中西医结合组40例和西医对照组40例。西医对照组给予西医综合治疗,中西医结合组在西医综合治疗的基础上加用解毒凉血健脾方,治疗8周。观察两组患者肝功能以及凝血功能指标,统计治疗后两组患者进展为慢加急性肝衰竭的病情进展率、治疗的累积有效率以及中医证候改善情况。结果治疗2周后,中西医结合组的累积有效率为70.0%(28/40),高于西医对照组的37.5%(15/40,P<0.05);中西医结合组病情进展率[12.5%(5/40)]低于西医对照组[17.5%(7/40)],两组比较差异无统计学意义(P>0.05)。治疗2、3、4、6及8周,中西医结合组ALT、AST与治疗前比较均显著下降(P<0.001),与同一时间点西医对照组比较差异无统计学意义(P>0.05);中西医结合组TBIL自治疗2周后显著下降,与治疗前比较差异均有统计学意义(P<0.05),较同期西医对照组明显降低(P<0.05);其余时间点,TBIL两组较治疗前均显著下降,但组间比较差异无统计学意义(P>0.05)。自治疗1周后,中西医结合组PTA明显升高(P<0.05),但与西医对照组同期比较差异无统计学意义(P>0.05)。中西医结合组治疗2周时,中医证候评分及MELD评分较西医对照组显著下降,(P<0.05)。结论解毒凉血健脾方能够降低乙型肝炎慢加急性肝衰竭高风险患者的病情进展率,提高治疗有效率,改善患者预后。
Objective To observe the efficacy of Jiedu Liangxue Jianpi Recipe(JLJR)in treating high risk group of hepatitis B virus(HBV)associated acute-on-chronic hepatitis B liver failure(AC-HBLF)patients with Gan-Dan dampness-heat,accumulation of evil toxin syndrome(GDDH-AETS).Methods Using PROC PLAN program of SAS 9.2 Software,a random scheme was developed to generate a sequence of random distribution schemes.Random serial numbers and grouping schemes were hidden by opaque sealed envelopes.HBV associated AC-HBLF patients with GDDH-AETS were randomly assigned the integrated Chinese and Western medicine(ICWM)group and the Western medicine(WM)control group,40 in each group.Patients in the WM control group received comprehensive WM treatment.Those in the ICWM group additionally took JLJR.All were treated for 8 successive weeks.The liver function and coagulation function indicators were dynamically measured.The progressive rate,the cumulative effective rate,and the improvement of Chinese medical syndromes were statistically calculated.Results After 2 weeks of treatment,the cumulative effective rate was 70.0%(28/40)in the ICWM group,higher than that of the control group[37.5%(15/40),P<0.05].The progressive rate was 12.5%(5/40)in the ICWM group,lower than that of the WM control group[17.5%(7/40)],but with no statistical difference between the two groups(P>0.05).After 2,3,4,6,and 8 weeks of treatment,ALT and AST in the ICWM group decreased significantly,as compared with pre-treatment(P<0.001),but with no statistical difference with the WM control group at the same time points(P>0.05).TBIL decreased significantly after 2 weeks of treatment,with statistical significance as compared with before treatment(P<0.05),significantly lower than that of the WM control group at the same time point(P<0.05).TBIL decreased significantly at the rest time points in the two groups after treatment,as compared with pre-treatment,but there was no statistical difference between the two groups(P>0.05).After 1 week of treatment,PTA significantly increas
作者
侯艺鑫
王宪波
杨志云
杨玉英
张群
李玉鑫
王浩宇
于浩
孟培培
江宇泳
HOU Yi-xin;WANG Xian-bo;YANG Zhi-yun;YANG Yu-ying;ZHANG Qun;LI Yu-xin;WANG Hao-yu;YU Hao;MENG Pei-pei;JIANG Yu-yong(Department of Integrative Medicine,Beijing Ditan Hospital,Capital Medical University,Beijing,100015)
出处
《中国中西医结合杂志》
CAS
CSCD
北大核心
2019年第11期1314-1319,共6页
Chinese Journal of Integrated Traditional and Western Medicine
基金
北京市医院管理局重点医学专业发展计划(No.ZYLX201707)
北京市科学技术委员会"首都临床特色应用研究"资助项目(No.Z181100001718052)
关键词
乙型肝炎
慢加急性肝衰竭
高风险
解毒凉血健脾方
hepatitis B virus
acute-on-chronic liver failure
high risk
Jiedu Liangxue Jianpi Recipe
