【摘要】 目的:观察土茯苓组方中西医结合治疗乙型肝炎病毒慢加急性肝衰竭(ACLF)患者的临床疗效。方法:采用前瞻性随机对照研究,设中西医结合治疗组44例和对照组22例;两组均给予综合内科治疗,中西医结合治疗组在综合内科治疗基础上加用土茯苓组方水煎剂,每天1-2次,5d为1个疗程。观察和对比两组治疗前后的总体疗效。结果:中西医结合治疗组好转率70.5%,平均住院天数(28.0±3.2)d,优于对照组好转率40.9%和平均住院天数(45.2±6.8)d(P<0.05);两组在治疗后发热、呃逆、下肢水肿、腹水、肝臭、合并感染及总胆红素(TBil)、凝血酶原活动度(PTA)、酶胆分离均较治疗前改善,而中西医结合治疗组呃逆、肝臭及TBil、PTA的改善更为显著(P<0.05);且其3个月和6个月生存率均优于对照组(P<0.05);ACLF早期及中期患者中西医结合治疗的好转率均高于晚期患者(P<0.05)。结论:土茯苓组方可提高ACLF的好转率,改善临床症状、肝功能和6个月内的生存率。更多还原

【Abstract】 Objective: To observe the clinical effects of smilax glabra rhizome composition of Chinese combined with western medicine on patients with hepatitis B combined with acute-on-chronic hepatic failure. Methods: Patients with hepatitis B combined with acute hepatic failure were divided into treatment group and control group with the method of prospective and randomized controlled study, each group for 44 cases and 22 cases, respectively. The control group was received the physical treatment of hepatitis B combined with acute hepatic failure, while the treatment was received smilax glabra rhizome composition decoction in addition to the physical treatment, twice per day, 5 days for a course. The overall clinical effects were observed and compared before and after the treatment. Results: The improvement rate and hospital stay in the treatment group were superior to those in the control group(P<0.05), with accounting for 70.5% and 40.9% and being(28.0±3.2) days and(45.2±6.8) days, respectively. The fever, hiccup, edema of lower extremity, ascites, hepatic fetor, infection, total bilirubin(TBil), prothrombin activity(PTA), biliary enzyme separation after treatment in 2 groups were all better than those before treatment. And, the hiccup, hepatic fetor, TBil and PTA in the treatment group were better than those in the control group(P<0.05). The 3 and 6 months survival rates in treatment group were higher than those in the control group(P<0.05). The improvement rates of the patients at the early and middle stage in the treatment group were higher than those of the patients at terminal stage(P<0.05). Conclusion: The smilax glabra rhizome composition has a remarkable effect on patients with hepatitis B combined with acute-on-chronic hepatic failure, which could increase the improvement rate, improve the clinical symptoms and liver function and raise the 6 months survival rate.更多还原