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目的:评价抗肝衰复方对急性、亚急性、慢性重型肝炎患者的临床治疗效果。方法:随机选择120例重型肝炎患者将其分为两组,对照组60例采用《病毒性肝炎防治方案》[1]确定的常规西药治疗,治疗组60例在常规西医治疗基础上加用抗肝衰复方(药物口服和/或灌肠)治疗,100m l/次,1剂/d,14天为1个疗程,连用3~4个疗程。观察临床症状、体征变化,比较肝功能、乙肝病毒血清标志物及常规生化指标改善情况,研究抗肝衰复方对重型肝炎患者主要并发症的干预效果,统计治疗的有效率及存活率。结果:治疗组有效率71.7%。显效率为48.3%,对照组有效率为51.7%,显效率为20.2%,差异均有显著性意义(P<0.05或P<0.01);治疗3个疗程后患者乏力、上腹不适、恶心、纳差、腹胀等临床症状及体征迅速缓解,血清总胆红素(TB il)、天门冬氨酸转氨酶(AST)、凝血酶原活动度(PTA)也明显改善,差异均有显著性意义(P<0.05或P<0.01)。而丙氨酸转氨酶(ALT)与对照组比较也有下降,但差异无显著性意义(P>0.05)。并发症在治疗3个疗程后均少于对照组,肝性脑病、肝肾综合征等并发症减少较对照组差异有显著性意义(P<0.05);治疗3个疗程后HBV DNA、HBeAg定量滴度与对照组比较均有加速下降趋势,但差异无显著性意义(P>0.05)。结论:抗肝衰复方有助于改善急性、亚急性、慢性重型肝炎患者的预后,是提高整体治疗重型肝炎疗效的有效措施之一。
Objective: To evaluate the clinical effect of Kangfeifei Recipe on acute, subacute and chronic severe hepatitis patients. Methods: A total of 120 patients with severe hepatitis were randomly divided into two groups. 60 patients in the control group were treated with conventional western medicine as defined in “Control and Prevention of Viral Hepatitis” [1]. Sixty patients in the treatment group were treated with conventional western medicine Liver failure prescription (oral and / or enema) treatment, 100m l / time, 1 / d, 14 days for a course of treatment, once every 3 to 4 courses. To observe the clinical symptoms and signs changes, compare the liver function, serum markers of hepatitis B virus and the improvement of routine biochemical indexes. To study the intervention effect of Kangfeifei Recipe on the main complication of severe hepatitis patients and the statistical treatment efficiency and survival rate. Results: The treatment group was 71.7% efficient. The effective rate was 48.3% in the control group and 51.7% in the control group, with a significant efficiency of 20.2% (P <0.05 or P <0.01). After 3 courses of treatment, the patients suffered from fatigue, abdominal discomfort, nausea, Anorexia, bloating and other clinical symptoms and signs of rapid relief, serum total bilirubin (TBil), aspartate aminotransferase (AST), prothrombin activity (PTA) also significantly improved, the differences were significant P <0.05 or P <0.01). Alanine aminotransferase (ALT) compared with the control group also decreased, but no significant difference (P> 0.05). Complications after treatment of three courses were less than the control group, hepatic encephalopathy, hepatorenal syndrome and other complications reduced compared with the control group was significantly different (P <0.05); after 3 courses of treatment of HBV DNA, HBeAg quantitative Compared with the control group, titers decreased at a faster rate, but the difference was not significant (P> 0.05). Conclusion: Kanggan Decoction can help to improve the prognosis of patients with acute, subacute and chronic severe hepatitis and is one of the effective measures to improve the curative effect of the whole treatment of severe hepatitis.