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目的评价中药高位保留灌肠对慢性乙型肝炎肝功能衰竭(肝衰竭)患者的早期疗效。方法 50例慢性乙型肝炎肝衰竭早期属中医湿热发黄证患者随机分为治疗组25例和对照组25例。对照组患者给予内科综合治疗;治疗组在此基础上予以中药保留高位灌肠,每日1次,疗程2周。比较两组患者治疗后临床疗效、两组有效患者治疗后腹胀改善时与黄疸消退时间、血清总胆红素(TBiL)、凝血酶原活动度(PTA)的变化。结果治疗组有效率为68%,对照组为40%,两组比较差异有统计学意义(P<0.05)。两组有效患者治疗后较治疗前TBiL明显下降(P<0.05),PTA明显升高(P<0.05);TBiL的下降和PTA的上升治疗组均优于对照组,差异有统计学意义(P<0.05)。治疗组治疗后腹胀改善时间、黄疸消退时间均少于对照组,差异有统计学意义(P<0.05)。结论对于慢性乙型肝炎肝衰竭证属湿热发黄证患者,在内科综合治疗的基础上,尽早予以中药高位保留灌肠有利于控制病情进展,改善预后。
Objective To evaluate the early effect of high retention enema of traditional Chinese medicine on patients with chronic hepatitis B liver failure (liver failure). Methods Fifty patients with chronic hepatitis B with liver failure were randomly divided into treatment group (25 cases) and control group (25 cases). Patients in the control group were given comprehensive medical treatment. On the basis of this, the treatment group was given high enema by traditional Chinese medicine once a day for 2 weeks. The curative effect of two groups of patients after treatment was compared. The change of jaundice, the total bilirubin (TBiL) and the activity of prothrombin (PTA) in the two groups after treatment were compared. Results The effective rate was 68% in the treatment group and 40% in the control group, with significant difference between the two groups (P <0.05). The effective TBIL of both effective groups were significantly decreased (P <0.05) and PTA was significantly increased after treatment (P <0.05). The decrease of TBiL and the increase of PTA in treatment group were better than the control group (P <0.05). The treatment group after treatment of abdominal distension to improve the time, jaundice subsided time were less than the control group, the difference was statistically significant (P <0.05). Conclusion For patients with chronic hepatitis B liver failure syndrome of damp-heat syndrome, on the basis of comprehensive medical treatment, early retention of enema of Chinese medicine is helpful to control the progression of the disease and improve the prognosis.