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目的观察健软四苓汤联合西药治疗慢性乙型肝炎重度黄疸的临床疗效。方法将74例慢性乙型肝炎重度黄疸患者随机分为治疗组38例和对照组36例。两组均采用护肝降酶、抗病毒等基础治疗及对症治疗,治疗组加用健软四苓汤治疗,每日1剂;对照组加用丁二磺酸腺苷蛋氨酸静脉滴注,每次1000mg,每日1次,两组均治疗4周后观察临床疗效。比较两组治疗前后总胆红素(TBiL)、内毒素、肿瘤坏死因子α(TNF-α),白细胞介素-6(IL-6)、丙氨酸氨基转移酶(ALT)、凝血酶原活动度(PTA)的水平及黄疸持续时间。结果治疗组总有效率为94.74%,对照组为61.11%,治疗组总有效率明显优于对照组(P<0.01)。两组患者治疗后TBiL、ALT、血浆内毒素、TNF-α、IL-6水平均较治疗前明显下降,差异有统计学意义(P<0.05或P<0.01)。治疗组治疗后TBiL、血浆内毒素、TNF-α、IL-6水平明显低于对照组(P<0.05或P<0.01)。治疗组患者黄疸持续时间显著短于对照组(P<0.05)。结论健软四苓汤联合西药治疗慢性乙型肝炎重度黄疸效果显著,可明显改善肝功能,缩短黄疸持续时间。
Objective To observe the clinical effects of Jianlian Suling Decoction combined with western medicine in treating severe jaundice with chronic hepatitis B. Methods Seventy-four patients with chronic hepatitis B severe jaundice were randomly divided into treatment group (38 cases) and control group (36 cases). Both groups were treated with liver-protecting enzyme, anti-virus and other basic treatment and symptomatic treatment, the treatment group with Jianlian Suling soup, day 1; control group with adenosine tributylsulfate intravenous infusion, each Times 1000mg, 1 day, two groups were treated for 4 weeks after the observation of clinical efficacy. The levels of total bilirubin (TBiL), endotoxin, tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), alanine aminotransferase (ALT), prothrombin Activity level (PTA) and jaundice duration. Results The total effective rate was 94.74% in the treatment group and 61.11% in the control group. The total effective rate in the treatment group was significantly better than that in the control group (P <0.01). After treatment, the levels of TBiL, ALT, plasma endotoxin, TNF-α and IL-6 in both groups were significantly lower than those before treatment, the difference was statistically significant (P <0.05 or P <0.01). TBiL, plasma endotoxin, TNF-α and IL-6 levels in the treatment group were significantly lower than those in the control group (P <0.05 or P <0.01). The duration of jaundice in treatment group was significantly shorter than that in control group (P <0.05). Conclusion Jianliang Suling Decoction combined with Western medicine treatment of severe chronic hepatitis B severe jaundice significantly, can significantly improve liver function and shorten the duration of jaundice.