中西医结合治疗乙型肝炎病毒相关肝衰竭的疗效分析  

Analysis the Curative Efficacy of Combination of Chinese and Western Medicine Treatment the Hepatitis B virus Associated Hepatic Failure

作　　者：王立福[1,2] 李筠[1] 李丰衣[1] 张晓峰 张明香[2] 曹武奎[3] 李芹[4] 温贤敏[5] 毛德文[6] 孙克伟 周小舟[8] 田德英 过建春[10] 杨大国[11] 李秀惠[12] 杨宏志 王宪波[14] 卓蕴慧[15] 张琴 李瀚旻[17] 扈晓宇[18] 赵伟[19] 张复春[20] 何丽云[21] Wang Li-Fu, Li Jun, Li Feng-Yi, et al.(Integrated Traditional Chinese and Western Medicine Center of Therapeutic Research for Liver Disease, the 302nd Hospital（ Beijing , 100039 ） China.)

机构地区：[1]中国人民解放军第三〇二医院,北京100039 [2]沈阳市第六人民医院 [3]天津市传染病医院 [4]福州市传染病医院 [5]成都市传染病医院 [6]广西中医学院第一附属医院 [7]湖南中医药大学第一附属医院 [8]深圳市中医院 [9]华中科技大学同济医学院附属同济医院 [10]杭州市第六人民医院 [11]深圳市第三人民医院 [12]首都医科大学附属北京佑安医院 [13]中山大学附属第三医院 [14]北京地坛医院 [15]上海中医药大学附属曙光医院 [16]上海公共卫生临床中心 [17]湖北省中医院 [18]成都中医药大学附属医院 [19]南京市第二医院 [20]广州市第八人民医院 [21]中国中医科学院临床评价中心

出　　处：《中西医结合肝病杂志》2018年第2期70-74,共5页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：国家“十一五”传染病重大专项课题资助项目(No.2008ZX10005-007)

摘　　要：目的:探讨中西医结合治疗方案治疗乙型肝炎病毒(HBV)相关慢加急性肝衰竭和慢性肝衰竭患者的疗效。方法:采用前瞻性、多中心、随机对照研究方法,HBV相关慢加急性肝衰竭和慢性肝衰竭患者,分别按2:1的比例进入治疗组和对照组,观察第8周、第12周、第24周、第48周病死率。结果:HBV相关慢加急性肝衰竭患者在第8周、12周、24周、48周,两组病死率间差异有统计学意义(P<0.05),治疗组病死率均明显低于对照组;早期、中期死亡率较低;晚期死亡率较高,两组患者生存曲线间齐性检验,p=0.0525,提示加用中药可能改善患者预后。HBV相关慢性肝衰竭患者在第8周、12周、24周、48周,两组病死率间差异无统计学意义(P>0.05)。结论:中西医结合治疗方案可降低乙肝病毒相关慢加急性肝衰竭患者病死率,尤其对晚期患者在缺乏肝移植等手段时,西医常规治疗联合中药治疗可改善患者生存率。Objective： To study the curative efficacy of Chinese and Western medicine treatment the virus hepatitis B virus associated acute-on-chronic liver failure and chronic hepatic failure. Methods： The perspective multicenter randomized control clinical trial was used.The patients who were liver failure and chronic hepatic failure had the ratio of 2： 1 access to treatment group and control group. Study the fatality rate between two groups in 8 weeks,12 weeks,24 weeks,and 48 weeks. Results： Patients＇ fatality rates about the hepatitis B virus associated acute-on-chronic liver failure had a significant difference between the two groups in 8 weeks,12 weeks,24 weeks and 48 weeks（ P〈0. 05）. The case fatalities were reduced obviously in treatment group. For the advanced stage patients suggested that traditional Chinese medicine may improve the prognosis,according the variance homogeneity（ P = 0. 0525）. For patients of the hepatitis B virus associated chronic hepatic failure,there was no statistical difference（ P〉0. 05） between the two groups in in 8 weeks,12 weeks,24 weeks and 48 weeks. Conclusion： The treatment prescription with the method of integrated traditional and western medicine in the virus hepatitis B virus associated acute-on-chronic liver failure can reduce the mortality,especially in the advanced stage that cannot have liver transplantation and other means.

关 键 词：肝衰竭 中西医结合 

分 类 号：R512.62[医药卫生—内科学] R575.3[医药卫生—临床医学]