利胆合剂对肝病综合征患儿的临床疗效及其对炎症因子的影响  

Clinical effect of Lidan mixture on infantile liver disease and its influence on inflammatory factors

作　　者：王芳[1] 鄢素琪[1] 邓玉萍[1] 万琦[1] 李红[1] 

机构地区：[1]湖北省武汉市妇女儿童医疗保健中心中西结合科,武汉430000

出　　处：《中国临床药理学杂志》2016年第6期520-522,共3页The Chinese Journal of Clinical Pharmacology

基　　金：武汉市应用基础研究计划基金资助项目(2013062301010807);湖北省中医药中西医结合科研基金资助项目(2010Z-Y18);湖北省自然科学面上基金资助项目(2012FFB05304)

摘　　要：目的观察利胆合剂对婴儿肝病综合征的临床疗效及其对炎症因子影响。方法 82例肝病综合征患儿随机分为试验组和对照组,每组41例。对照组患儿给予更昔洛韦抗病毒治疗,诱导期5 mg·kg^(-1),每天2次,连用14 d;维持期5mg·kg^(-1),每天1次,连用14 d。试验组患儿在此基础上加用利胆合剂口服或灌肠治疗,28 d为1个周期。比较2组患儿的临床疗效、巨细胞病毒免疫球蛋白M(CMV-IgM)转阴率、症状消失时间、肝功能指标、炎症因子变化水平和不良反应发生率。结果试验组患儿治疗有效率和CMV-IgM转阴率分别为92.7%和87.8%,显著高于对照组的75.6%和68.3%(P<0.05)。试验组黄疸消退天数、肝脾回缩天数显著低于对照组(P<0.05),但体重增长差异无统计学意义(P>0.05)。试验组患儿治疗后总胆红素、直接胆红素、丙氨酸氨基转移酶、总胆酸、γ-谷氨酰转肽酶水平均显著低于治疗前和对照组(P<0.05)。试验组患儿肿瘤坏死因子α和白细胞介素6水平分别为(206.7±48.6),(29.7±5.0)ng·L^(-1),显著优于对照组的(283.6±34),(38.9±3.1)ng·L^(-1)(P<0.05)。2组患儿不良反应发生率差异无统计学意义(P>0.05)。结论中西医结合治疗对婴儿肝病综合征临床疗效显著,通过减轻患儿炎症反应改善整体症状。Objective To investigate the clinical effect of Lidan mixture in the treatment of infantile liver disease and its influence in inflammatory factors. Methods Eight-two infants with liver disease syndrome were randomly divided into treatment group and control group,41 cases in each group. Control group was treated with ganciclovir 5 mg · kg^（-1）,q12 h for 14 d and 5 mg·kg^（-1）,qd,for 14 d. Patients in treatment group were treated with Lidan mixture additionally,28 d a course. The clinical effect,cytomegalovirus immunoglobulin M（ CMV-IgM） negative rate,symptoms disappeared time,changes of liver function,inflammatory factor levels and adverse reactions incidence were compared between the two groups. Results The effective rate and CMV-IgM negative rate in treatment group were 92. 7% and 87. 8%, significantly higher than75. 6% and 68. 3% in control group（ P〈0. 05）. The jaundice subsided and hepatosplenomegaly retraction time in treatment group were significantly lower than those in control group（ P〈0. 05）,but body weightgains had no significant difference（ P〈0. 05）. After treatment,the levels of total bilirubin（ TBi L）,direct bilirubin（ OBi L）,alanine aminotransferase（ ALT）,total bile acid（ TBA）,γ-glutamyltranspeptidase（ GGT） in treatment group were significantly lower than those in control group（ P〈0. 05）. The levels of interleukin 6（ IL-6） and tumor necrosis factor-α（ TNF-α） in treatment group were（ 206. 7 ± 48. 6）,（ 29. 7 ± 5. 0） ng ·L^（-1）,significantly better than（ 283. 6 ± 34）,（ 38. 9 ± 3. 1） ng·L^（-1）in control group（ P〈0. 05）. There was no significant difference in the incidence of adverse reactions between the two groups（ P〈0. 05）. Conclusion The integrated traditional Chinese and western medicine has obvious curative effect on infantile liver disease syndrome,improving the overall symptoms of children by reducing the inflammatory reaction.

关 键 词：婴儿肝病综合征 利胆合剂 中西医结合 临床疗效 炎症因子 

分 类 号：R725.7[医药卫生—儿科]