茵陈四逆汤加减治疗慢加急性肝衰竭  

Efficacy of Modified Yinchen Sini Tang in Acute-on-Chronic Liver Failure

作　　者：陈月桥[1] 毛德文[1] 唐农[1] 刘力红[1] 王娜[1] 

机构地区：[1]广西中医药大学第一附属医院,南宁530023

出　　处：《中国实验方剂学杂志》2015年第18期163-166,共4页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家"重大新药创制"科技重大专项(2012ZX10005005-001-002);广西自然科学基金项目(2012GXNSFAA053121);2014年广西高校高水平创新团队及卓越学者项目

摘　　要：目的:观察茵陈四逆汤治疗慢加急性肝衰竭阴黄证的临床疗效。方法:将符合纳入标准的260例慢加急性肝衰竭阴黄证患者随机分为对照组及治疗组(各130例),对照组予西医综合治疗为主,治疗组在西医综合治疗基础上予茵陈四逆汤辨证加减治疗,疗程为8周,比较入组前组间基线特征,记录治疗前后患者症状体征积分、肝功能[包括总胆红素(total bilirubin,TBIL),丙氨酸氨基转移酶(alanine aminotransferase,ALT),血清白蛋白(serum albumin,ALB)],凝血功能[凝血酶原活动度(primary trait analysis,PTA)],终末期肝病模型(MELD)评分(model for end-stage liver disease)变化情况,比较两组患者中医证候疗效,8周治疗效果及短期(12周)的预后差异。结果:治疗组症状体征积分下降明显优于对照组(P<0.01),中医证候总有效率治疗组为87.90%,对照组为60.83%,差异比较有显著性意义(P<0.05),两组患者治疗后TBIL,ALT,ALB,PTA,MELD评分改善程度比较,差异有显著性意义(P<0.01),8周治疗后总有效率比较,治疗组91.54%,优于对照组53.85%(P<0.01),两组随访12周,治疗组存活率高于对照组(P<0.05)。结论:茵陈四逆汤治疗慢加急性肝衰竭阴黄证能显著改善患者临床症状、保护肝脏功能,提高存活率,优于单一西医综合治疗。Objective ： To investigate the efficacy of modified Yinchen Sini Tang in treating patients with acute-on-chronic liver failure （ACLF） characterized by Yin jaundice syndrome. Method： Two hundred and sixty eligible patients with ACLF characterized by Yin jaundice syndrome were randomly divided into the control group （n = 130） and the treatment group （n = 130）. They were respectively given the simple comprehensive western therapy and the combined therapy with modified Yinehen Sini Tang for 8 weeks. Baseline characteristics were compared between both groups before and after the treatment. Before and after treatment, patients＇ symptoms and signs score, liver function [ including alanine aminotransferase （ALT）, total bilirubin （TBIL） and albuminalbumin （ALB）], primary trait analysis （PTA）, model for end-stage liver disease （MELD） changes were recorded, and traditional Chinese medicine （TCM） syndromes, 8-week treatment effect and short-term （12 weeks） differences in prognosis of two groups were compared. Result： The treatment group was significantly superior to the control group in symptom scores （P 〈 0.01 ）. In the overall response rate of TCM symptoms, the treatment group was 87.90% , while the control group was 60. 83% , with a significant difference （P 〈 0.05 ）. After treatment, both groups showed improvements in TBIL, ALT, ALB, PTA, MELD scores, the difference was significant （P 〈 0.01 ）. At the 8^th week after treatment, the overall response rate in the treatment group were significantly higher than the control group （91.54% VS 53.85% ） （P 〈 0.01 ）. At the 12^th week, more patients were survived in the treatment group than the control group （P 〈 0.05）. Conclusion ： Modified Yinchen Sini Tang can relieve clinical symptoms of patients with ACLF characterized by Yin jaundice syndrome and protect the liver,with a superior efficacy than the simple comprehensive western therapy.

关 键 词：茵陈四逆汤 慢加急性肝衰竭 阴黄证 

分 类 号：R287.6[医药卫生—中药学]