中西医结合治疗肝衰竭的疗效评价  

Curative Effect Evaluation of Integrated Traditional Chinese Medicine and Western Medicine on Treating Liver Failure

作　　者：陈定潜[1] 曾义岚[1] 胡蓉[1] 王林[1] 王丽[1] 刘大凤[1] 叶庆[1] 李继科[1] 高峰[1] 段萌[1] 毛创杰[1] 李守娟[1] 

机构地区：[1]成都市传染病医院国家中医药管理局中医药防治传染病重点研究室,四川成都610061

出　　处：《四川中医》2013年第7期61-64,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：四川省中医药管理局2012~2013年度专项经费资助(编号:20122A-09)

摘　　要：目的:观察中西医结合联合人工肝治疗肝衰竭的疗效。方法:采用前瞻性随机对照研究,将符合纳入排除标准的肝衰竭患者随机分入中西医结合组、西医组。治疗8周。比较两组死亡率、并发症发生率、生化及凝血指标改善的差异。结果:1)基线时两组性别、年龄、病程、家族史、病因、病原型别、肝衰竭分型分期、并发症、生化指标、凝血功能及病毒学指标均相似,具有可比性;2)4周结束时中西医结合组死亡率明显低于西医组(7.69%VS25.00%,P=0.087);3)4周结束时中西医结合组原发性腹膜炎的发生率明显低于西医组(15.38%VS 43.75%,P=0.021),肝性脑病、肝肾综合征、消化道出血及电解质紊乱的发生率均略低于西医组;4)自治疗后第1周末始至第4周结束时中西医结合组总胆红素较西医组明显降低,尤其在第2周结束时、3周结束时(分别为198.63 VS235.32,133.28 VS 220.93,83.58 VS 154.08,67.38 VS 92.58,P=0.306、0.014、0.012、0.203);第1周结束时至3周结束时中西医结合组ALT及AST略低于西医组,ALB及PTA略高于西医组。结论:中西医结合联合人工肝治疗能改善肝衰竭患者的肝功能及凝血功能、降低肝衰竭患者短期(4周结束时)的死亡率、减少并发症的发生。Objective： To evaluate the curative effect of Traditional Chinese Medicine on the basis of western medicine to gether with nonbioardtlcial liver treatment for liver failure. Methods ： Using the prospective, randomized controlled research. Ca ses of liver failure who would integrate the elimination standard along with the enroll standard, stochastically entered the controlled group （western medicine together with nonbioartificial hver） and the treatment group （Traditional Chinese Medicine onthe basis of western medicine together with nonbioartificial liver）. To analyze the differences of mortality rate, survival time, in cidence of complications, biochemical and coagulation parameters to improve at different time node in two groups. Results ： 1 ） At baseline, sex, age, disease duration, family history, etiology, pathogen type, type and stage of liver failure, incidence of complications, biochemical parameters, blood coagulation parameters and virological indicators were similar to each other in two groups. So at baseline it has comparability in two groups. 2） The mortality rate in the treatment group was significantly lower than that in the control group （7. 69% VS 25.00%, P = 0. 087） at the end of four weeks. 3） Incidence of primary peritonitis in the treatment group was significantly lower than that in the controlled group （ 15. 38% VS 43.75%, P=0. 021 ）. Incidence of hepatic encephalopathy, hepatorenal syndrome, gastrointestinal bleeding and electrolyte disturbance in the treatment group was a little lower than that in the controlled group. 4） Total bilirubin in the treatment group was significantly lower than that in the controlled group from first week to the end of four weeks （ 198.63 VS 235.32, 133.28 VS 220. 93, 83.58 VS 154. 08, 67.38 VS 92.58, P=0. 306, 0. 014, O. 012, 0. 203 respectively）, especially at the end of two and three weeks. In the treatment group alanine aminotransferase, aspartate transaminase were a little lower and serum albumin, prothrombin activity were

关 键 词：肝衰竭 中医治疗 西医综合治疗 人工肝治疗 疗效 

分 类 号：R575.3[医药卫生—消化系统]