复方大黄煎剂保留灌肠治疗肝硬化肝性脑病临床观察  

Clinical Observation on Retention Enema with Compound Rhubarb Decoction on Hepatic Encephalopathy due to Cirrhosis

作　　者：陈舒婷 胡甜 彭莉 CHEN Shuting;HU Tian;PENG Li(Department of Hepatology,the First Affliated Hospital of Hunan University of Chinese Medicine,Hunan Province,Changsha 410007,China)

机构地区：[1]湖南中医药大学第一附属医院肝病科,湖南长沙410007

出　　处：《光明中医》2022年第13期2298-2301,共4页GUANGMING JOURNAL OF CHINESE MEDICINE

摘　　要：目的探讨复方大黄煎剂保留灌肠治疗肝硬化肝性脑病(Hepatic encephalopathy,HE)患者的临床疗效。方法收集2017年1月—2020年12月湖南中医药大学第一附属医院收住入院的肝硬化肝性脑病患者287例,依据治疗方案,分为内科常规治疗组(对照组)75例、内科常规治疗联合乳果糖保留灌肠组(A组)100例、内科常规治疗联合中药保留灌肠组(B组)112例。比较3组之间的临床疗效、不良反应及生存质量变化情况。结果A组、B组的疗效明显高于对照组(P<0.05),A组与B组疗效差异无统计学意义。3组治疗后白蛋白(Albumin,ALB)较治疗前均升高(P<0.05),丙氨转氨酶(Alanine aminotransferase,ALT)、谷草转氨酶(Aspartate aminotransferase,AST)、总胆红素(Total bilirubin,TBil)、内毒素(Lipopolysaccharide,LPS)及血氨(Serum ammonia,NH3)较治疗前均下降(P<0.05),A组和B组下降幅度明显大于对照组(P<0.05);其中B组治疗后ALT、TBil、NH3改善效果明显优于A组(P<0.05)。3组患者治疗后均未出现严重不良反应。3组患者治疗后的生理健康、心理状态、社会关系、与周围环境的关系评分均明显高于治疗前和同期对照组。结论复方大黄煎剂保留灌肠能显著提高肝硬化肝性脑病患者的临床疗效,可有效降低外周血LPS、NH3水平,促进肝功能恢复,及提升患者生活质量,值得临床推广应用。Objective To investigate the clinical effect of compound Rhubarb decoction retention enema in the treatment of patients with hepatic encephalopathy due to cirrhosis.Methods A total of 287 patients with liver cirrhosis complicated with hepatic encephalopathy admitted to the department of hepatology of the First Affiliated Hospital of Hunan University of Chinese Medicine from January 2017 to December 2020 were selected.According to the treatment plan,they were divided into routine medical treatment group(control group)of 75cases,routine medical treatment combined with lactulose retention enema group(group A)of 100 cases,and routine medical treatment combined with traditional Chinese medicine retention enema group(group B)of 112 cases.The clinical efficacy,adverse reactions and quality of life were compared.Results The curative effect of group A and group B was significantly higher than that of the control group(P<0.05).Albumin(ALB)in the three groups after treatment was higher than that before treatment(P<0.05).At the same time,alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),lipopolysaccharide(LPS)and serum ammonia(NH3)were decreased compared with those before treatment(P<0.05),and the decrease in group A and group B was significantly greater than that in the control group(P<0.05).After treatment,ALT,TBIL and NH3 in group B were significantly better than those in group A(P<0.05).There were no serious adverse reactions in the three groups after treatment.After treatment,the scores of physical health,psychological status,social relations and the relationship with the surrounding environment of the three groups were higher than those of the control group and before treatment.Conclusion Compound rhubarb decoction retention enema can significantly improve the clinical efficacy of liver cirrhosis patients with hepatic encephalopathy.It can effectively reduce the levels of LPS and NH3,promote the recovery of liver function,and improve the quality of life of patients,which is worthy of c

关 键 词：复方大黄煎剂 肝硬化 肝性脑病 保留灌肠 中医外治疗法 

分 类 号：R259[医药卫生—中西医结合]