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目的观察中西医结合治疗乙型肝炎病毒(HBV)相关慢加急性肝衰竭(ACLF)的临床疗效。方法采用开放式随机对照方法,将观察组和对照组按2∶1比例入组,对照组给予西医基础治疗,观察组在此基础上联合凉血解毒化瘀法辨证用药,2组均治疗8周。在0、4、8周时点检测血清总胆红素(T-BIL)、直接胆红素(D-BIL)、血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、白蛋白(ALB)、胆碱酯酶(Ch E)和凝血酶原活动度(PTA)、国际标准化比值(INR)。结果 2组4、8周与0周时比较,T-BIL、D-BIL、ALT、AST、ALB、CHE、PTA、INR差异均有统计学意义(P<0.05);4周时2组间T-BIL、D-BIL、PTA差异有统计学意义(P<0.05);8周时2组间T-BIL、ALT、AST、ALB、PTA、INR差异均有统计学意义(P<0.05)。结论中西医结合疗法对肝功能和凝血功能的改善优于单纯西医基础治疗,随着治疗时间的延长,对肝功能和凝血功能的改善更明显。
Objective To observe the clinical efficacy of integrated traditional Chinese and western medicine in the treatment of hepatitis B virus (HBV) -related chronic acute liver failure (ACLF). Methods The open-label randomized controlled trial was adopted. The observation group and the control group were treated with 2: 1 ratio. The control group was treated with western medicine. The observation group was treated with the method of cooling-heat, detoxifying and resolving stasis, and the two groups were treated with 8 week. Serum total bilirubin (T-BIL), direct bilirubin (D-BIL), serum alanine aminotransferase (ALT), aspartate aminotransferase AST, ALB, ChE and PTA, and the international normalized ratio (INR). Results There were significant differences in T-BIL, D-BIL, ALT, AST, ALB, CHE, PTA, INR between the 4th and 8th week and the 2nd week There were significant differences in T-BIL, ALT, AST, ALB, PTA and INR between the two groups at 8 weeks (P <0.05) . Conclusion Integrative treatment of liver function and coagulation improved better than simple Western medicine treatment, with the extension of treatment time, the improvement of liver function and coagulation function more obvious.