甘露消毒丹联合退黄汤治疗慢加急性肝衰竭湿热蕴结证患者的临床观察  

Clinical observation of Ganlu Xiaodu Pellet combined with Tuihuang Decoction in treating acute-on-chronic liver failure of damp heat pattern

作　　者：丁晓娟 邹晓华[2] 张红梅[1] DING Xiaojuan;ZOU Xiaohua;ZHANG Hongmei(Anhui University of Chinese Medicine,Hefei,Anhui 230038,China;The First Hospital of AnhuiUniversity of Chinese Medicine,Hefei,Anhui 230038,China)

机构地区：[1]安徽中医药大学中医学院,安徽合肥230038 [2]安徽中医药大学第一附属医院,安徽合肥230038

出　　处：《湖南中医药大学学报》2023年第6期1049-1053,共5页Journal of Hunan University of Chinese Medicine

基　　金：新安医学教育部重点实验室开放基金项目(2022XAYX02);安徽高等学校省级质量工程项目(2021xskc055)。

摘　　要：目的探讨甘露消毒丹联合退黄汤治疗慢加急性肝衰竭湿热蕴结证患者的临床疗效。方法选择安徽中医药大学第一附属医院就诊的慢加急性肝衰竭患者74例,根据随机数字表法分为对照组与观察组,各37例,两组均给予西药常规治疗,对照组患者给予退黄汤灌肠治疗,观察组在对照组基础上给予甘露消毒丹口服治疗,水煎服400 mL,日1剂,分早晚2次,饭后温服各200 mL,连续治疗8周。观察两组治疗前后临床疗效;进行中医证候评分;检测丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天冬氨酸氨基转移酶(aspartate aminotransferase,AST)、白蛋白(albumin,ALB)以及总胆红素(total bilirubin,TBIL)评价肝功能;检测凝血酶原时间(prothrombin time,PT)、凝血酶原活动度(prothrombin time activity,PTA)评价凝血功能;腹部彩超检查肝右叶厚度、门静脉内径和胆囊壁厚度。结果治疗后观察组总有效率91.89%,显著高于对照组的70.27%(P<0.05)。治疗后两组中医证候评分均较治疗前降低,且观察组低于对照组(P<0.05)。治疗后两组ALT、AST、TBIL指标均较治疗前降低,ALB较治疗前升高,且观察组优于对照组(P<0.05)。治疗后两组PT指标均较治疗前降低,两组PTA指标均较治疗前升高,且观察组优于对照组(P<0.05)。治疗后两组门静脉内径、胆囊壁厚度均较治疗前降低,肝右叶厚度较治疗前升高,且观察组优于对照组(P<0.05)。结论甘露消毒丹联合退黄汤治疗慢加急性肝衰竭患者具有一定临床疗效。Objective To investigate the clinical efficacy of Ganlu Xiaodu Pellet combined with Tuihuang Decoction in treating acute-on-chronic liver failure(ACLF)of damp heat pattern.Methods Totally 74 patients with ACLF were selected from the First Hospital of Anhui University of Chinese Medicine.Then,they were divided into control group and observation group,with 37 cases in each group according to random number table method.Both groups were given conventional western medicine treatment.The control group received Tuihuang Decoction enema,while the observation group was administered with Ganlu Xiaodu Pellet on the basis of control group,with the warm decoction of 200 mL ante cibum and 200 mL post cibumor,for 8 consecutive weeks.The clinical efficacy of two groups before and after treatment were observed to determine TCM pattern scores.The liver function was evaluated by measuring alanine aminotransferase(ALT),aspartate aminotransferase(AST),albumin(ALB)and total bilirubin(TBIL).The coagulation function was tested by inspecting prothrombin time(PT),and prothrombin time activity(PTA).The thickness of right liver lobe,portal vein diameter,and gallbladder wall thickness were checked by abdominal color ultrasound.Results After treatment,the total effective rate of observation group was 91.89%,notably higher than 70.27%of control group(P<0.05).After treatment,TCM pattern scores of both groups were lower than those before treatment,and those of observation group were lower than those of control group(P<0.05).After treatment,the indexes of ALT,AST and TBIL of two groups were lower than those before treatment,and the ALB was higher than that before treatment,and the those of observation group were better than those of control group(P<0.05).After treatment,PT indexes in both groups were lower than those before treatment,PTA indexes in both groups were higher than those before treatment,and observation group showed better than control group(P<0.05).After treatment,the portal vein diameter and gallbladder wall thickness of both groups

关 键 词：甘露消毒丹 退黄汤 慢加急性肝衰竭 湿热蕴结证 肝功能 凝血功能 

分 类 号：R285.5[医药卫生—中药学]