凉血解毒化瘀方联合中药灌肠治疗慢加急(亚急)性肝衰竭湿热瘀黄证临床研究  

Clinical Study on Liangxue Jiedu Huayu Formula Combined with TCM Enema in Treatment of Acute Chronic(Subacute) Liver Failure of Damp Heat and Stasis Yellow Syndrome

作　　者：刘政芳[1] 黄伟[2] 李芹[1] 林恢[1] 刘丽[2] 

机构地区：[1]福州市传染病医院,福建福州350025 [2]福建中医药大学,福建福州350000

出　　处：《中国中医药信息杂志》2016年第2期37-41,共5页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：国家科技重大专项(2012ZX10005-005);福州市科技计划项目(2013-S-125-7)

摘　　要：目的观察凉血解毒化瘀方联合中药灌肠治疗慢加急(亚急)性肝衰竭湿热瘀黄证的临床疗效。方法将50例慢加急(亚急)性肝衰竭湿热瘀黄证患者随机分为治疗组30例和对照组20例。对照组予西医综合治疗,治疗组在此基础上予凉血解毒化瘀方口服治疗8周,并于第1周采用生理盐水结肠灌洗及大黄乌梅合剂保留灌肠。治疗开始后0、4、8、12、24周时观察2组患者丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBil)、血氨(NH3+)、CD3+、CD4+、CD8+、自然杀伤细胞(NK)、凝血酶原活动度(PTA)、白细胞介素(IL)、干扰素-γ(IFN-γ)变化,并进行终末期肝病模型(MELD)评分。结果治疗开始后4周,2组患者各项指标均较基线水平明显改善,试验组TBil、IL-4、IL-6低于对照组(P<0.05,P<0.01)。8周时,试验组AST、TBil、IL-6均低于对照组(P<0.05),PTA高于对照组(P<0.01)。12周时,试验组TBil、PTA、IL-5、IL-6、IFN-γ与对照组比较差异有统计学意义(P<0.05),且CD8+明显高于对照组(P<0.01)。24周时,试验组ALT、NH3+、CD4+、CD8+、NK、IL-2、IL-6与对照组比较差异有统计学意义(P<0.05),且TBil明显低于对照组(P<0.01)。结论凉血解毒化瘀方联合中药灌肠治疗慢加急(亚急)性肝衰竭湿热瘀黄证有助于黄疸的消退和提高PTA,对部分炎症细胞因子降低有积极作用。Objective To observe the clinical efficacy of Liangxue Jiedu Huayu Formula combined with TCM enema in the treatment of acute chronic(subacute) liver failure of damp heat and stasis yellow syndrome. Methods Fifty cases of acute chronic(subacute) of liver failure with damp heat and stasis yellow syndrome were randomly divided into treatment group(30 cases) and control group(20 cases). The control group was treated with Western medicine therapy, while treatment group orally took Liangxue Jiedu Huayu Formula based on basic treatment for 8 weeks, and received normal saline colonic for lavage and Rhei Radix et Rhizoma-Mume Fructus Mixture retention for enema in the first week. ALT, AST, TBil, NH3+, CD3+, CD4+, CD8+, NK, PTA, IL and IFN-γ in the two groups were observed in the 0, 4, 8, 12, and 24 weeks after the start of treatment. Model for end-stage liver disease(MELD) score was evaluated. Results In 4-week after the start of treatment, baseline levels of all indexes were improved significantly in the two groups(P<0.05, P<0.01). TBil, IL-4 and IL-6 in the treatment group were lower than the control group(P<0.05). In 8-week, AST, TBil and IL-6 in the treatment group were lower than the control group(P<0.05), and PTA was higher than the control group(P<0.01). In 12-week, TBil, PTA, IL-5, IL-6 and IFN-γ in the treatment showed statistical significance compared with the control group(P<0.05), and CD8+ was higher than the control group(P<0.01). In 24-week, ALT, NH3+, CD4+, CD8+, NK, IL-2 and IL-6 in the treatment showed statistical significance compared with the control group(P<0.05), and TBil was significantly lower than the control group(P<0.01). Conclusion Liangxue Jiedu Huayu Formula combined with TCM enema in the treatment of acute chronic(subacute) liver failure of damp heat and stasis yellow syndrome can help the recession of jaundice and improve the activity of thrombin, which has a positive role in reducing partial inflammatory cytokines.

关 键 词：慢加急(亚急)性肝衰竭 凉血解毒化瘀方 湿热瘀黄证 临床研究 

分 类 号：R259.753[医药卫生—中西医结合]