利湿攻下法治疗重型肝炎临床研究  

Clinical Study on Treatment of Severe Hepatitis with Removing Dampness and Purgative Method

作　　者：张建军[1] 黄加权[2] 

机构地区：[1]武汉大学医学院附属湖北省中山医院感染科,武汉430033 [2]华中科技大学同济医院感染科

出　　处：《中国中西医结合杂志》2008年第1期13-16,共4页Chinese Journal of Integrated Traditional and Western Medicine

摘　　要：目的评价利湿攻下法对急性、亚急性、慢性重型肝炎患者的临床治疗效果。方法随机选择120例重型肝炎患者将其分为两组,对照组60例采用常规西医综合治疗,治疗组60例,在对照组治疗基础上加用利湿攻下法组方口服和(或)灌肠治疗,14天为1个疗程,连用3个疗程。观察两组患者临床症状、体征变化,记录并发症,比较肝功能、乙型肝炎病毒血清标志物及血生化指标改善情况。并随访6个月。结果治疗组总有效率71.7%(43/60例),显效率为48.3%(29/60例),对照组总有效率为51.7%(31/60例),显效率为20.0%(12/60例),组间比较差异有统计学意义(P<0.05);治疗后治疗组各临床症状、体征好转例数及各主要并发症改善率均高于对照组(P<0.05,P<0.01)。治疗后两组ALT、AST、总胆红素(TBil)、HBV-DNA及HBeAg定量较治疗前均显著降低(P<0.01),白蛋白(ALB)、凝血酶原活动度(PTA)及胆固醇(TC)较治疗前均明显升高;治疗后两组间AST、TBil、PTA及HBV-DNA定量的比较,差异均有统计学意义(P <0.05,P<0.01)。随访6个月期间,治疗组病死率为23.3%(14/60例),对照组为41.6%(25/60例),两组比较差异有统计学意义(P<0.05)。结论利湿攻下法有助于改善重型肝炎患者的预后,是提高整体治疗重型肝炎疗效的有效措施之一。Objective To evaluate the clinical effect of removing dampness and purgative （RDP） method in treating acute, subacute and chronic severe hepatitis. Methods One hundred and twenty cases of severe hepatitis were randomly assigned to 2 groups, 60 patients in the control group were treated with routine Western medicine, 60 patients in the treatment group were treated with the same Western medicine plus Chinese medicine prescribed based on RDP principle orally and/or via enema. Fourteen days of treatment constituted one therapeutic course, and patients were treated for 3 courses. Changes of clinical symptoms and signs, complication occurrence, liver function, serum markers of hepatitis B virus, and some biological indexes were observed and compared. The case fatality rate was compared after a 6-month follow-up. Results The total effective rate and marked improving rate in the treatment group was 71.7% （43/60 cases） and 48. 3% （29/60 cases） respectively, while those in the control group, 51.7% （31/60 cases） and 20.0% （ 12/60 cases） respectively, showing significant difference between the two groups （P 〈0.05）. After treatment, the clinical symptoms and signs were relieved and complications were reduced in the treatment group, showing marked improvement as compared with that in the control group （P 〈 0.05）. ALT, AST, TBil, quantitative titer of HBV-DNA and HBeAg decreased markedly, and ALB, prothrom- base activity （PTA） and total cholesterol （TC） increased significantly in both groups after treatment （P 〈 0.01 ）. Significant difference was found in AST, TBil, PTA and quantitative titer of HBV-DNA between the two groups （P 〈0. 05, P 〈0. 01 ）. In the 6-month follow-up, the case fatality rate was 23.3% （ 14/60 cases） in the treatment group, significantly lower than that in the control group （P 〈 0.05 ）, which was 41.6% （25/60 case） Conclusion RDP treatment is helpful to improve the prognosis of patients with severe hepatitis, it is one of the effective mea

关 键 词：利湿攻下法 重型肝炎 临床疗效 

分 类 号：R259[医药卫生—中西医结合]