大黄煎剂保留灌肠联合西药治疗肝性脑病多中心随机平行对照研究  

A Multi-center Randomized Parallel-controlled Clinical Study on Efficiency of Rhubarb Decoction Retention Enema Combined with Western Medicine in Treating Hepatic Encephalopathy

作　　者：周智恩[1] 卢萍[1] 韩丽[2] 刘艳 雷晋豪 

机构地区：[1]成都市中西医结合医院重症医学科,四川成都610017 [2]山东省肿瘤医院肿瘤内科,山东济南250117 [3]成都九洲医院中西医结合科,四川成都610031

出　　处：《辽宁中医杂志》2014年第9期1918-1921,共4页Liaoning Journal of Traditional Chinese Medicine

摘　　要：目的:观察大黄煎剂保留灌肠联合西药治疗肝性脑病疗效。方法:使用随机平行对照方法,将164例住院患者按抽签方法随机分为两组,对照组62例,给予西医综合治疗。治疗组102例,加用大黄煎剂(醋大黄30 g,乌梅30 g,川朴15 g)水煎200 mL,2剂/d,早晚灌肠,西药治疗同对照组。均连续治疗7 d为1个疗程。观察临床症状,苏醒时间,扑翼样震颤消失时间,血氨水平,肝功能指标,数字连接实验(NCT)及SF-36生活质量表。连续治疗1疗程,判定疗效。结果:治疗组显效54例,有效40例,无效8例,总有效率92.16%。对照组显效27例,有效23例,无效12例,总有效率80.65%。治疗组疗效优于对照组(P<0.05);治疗组的苏醒时间和扑翼样震颤消失时间明显短于对照组(P<0.05);血氨及肝功能两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01,P<0.05);NCT及SF-36生活质量表评分两组均有改善(P<0.01,P<0.05),治疗组改善优于对照组(P<0.05)。均无明显不良反应。结论:大黄煎剂灌肠联合西药治疗肝性脑病疗效显著,值得推广。Objective ： To observe the clinical effect of treating hepatic encephalopathy with Rhubarb decoction retention enema combined with western medicine. Methods ： 164 patients according to the draw method were randomly divided into two groups. The control group with 62 cases was treated with conventional routine. The treatment group with 102 cases added Rhubarb decoction, two packages each day ,twice a day ,for 7 days. The clinical symptoms ,the time to resuscitation and the disappearance of flapping wing- like tremor, blood ammonia ,liver function, number connection test（NCT） and SF- 36 life quality scale were observed. Re- sults ： In the treatment group, markedly effective 54 cases, effective 28 cases, invalid 8 cases, the total efficiency was 92. 16%. In the control group, markedly effective 27 cases, effective 23 cases, invalid 12 cases, the total efficiency was 80. 65 %. The treatment group significantly improved compared with control group（p 〈 0. 05 ）. The treatment group had significant shorter time to resusci- tation and the disappearance of flapping wing -like tremor compared with the control group （p 〈 0. 05 ）. Blood ammomia, liver function,NCT and SF- 36 life quality of the two groups were all improved（ P 〈0.05 ,p 〈 0.01 ）. The treatment group was better than control group（p 〈 0. 05）. No obvious adverse event was seen in the treatment period. Conclusion：Rhubarb decoction retention enema combined with western in treating hepatic encephalopathy is a significant effective treatment and it is worth popularizing.

关 键 词：肝性脑病 大黄煎剂 保留灌肠 血氨 中西医结合治疗 多中心随机平行对照研究 

分 类 号：R742[医药卫生—神经病学与精神病学]