摘要
目的观察肠毒清颗粒对慢性重型乙型肝炎（乙肝）肠源性内毒素血症的疗效。方法将96例慢性重型乙肝肠源性内毒素血症患者随机分为治疗组及对照组，每组48例。对照组给予西医综合治疗；治疗组在综合治疗基础上口服肠毒清颗粒（组成：人参10g，厚朴6g，大黄6g，枳实6g，赤芍10g）；两组疗程均为4周。观察两组临床疗效、临床症状改善情况，治疗前后肝功能、凝血功能指标及血清内毒素（ET）水平的变化。结果治疗组总有效率明显高于对照组（62．50％比45．83％），病死率明显低于对照组（14．58％比33．33％，均P〈0．05）。两组治疗后临床症状均明显改善，且治疗组乏力、腹胀评分（分）明显低于对照组（乏力：3．31±0．22比6．42±0．77，腹胀：3．15±0．21比6．44±0．62，均P〈0．05）。两组治疗后总胆红素（TBil）水平明显降低，肝功能及凝血功能明显改善，凝血酶原活动度（PA）明显提高，且治疗组TBil及PA改善情况优于对照组CTBil（μmol／L）：94．6±52．3比124．6±64．4，PA：（52．8±11．5）％比（44．4±10．2）％，均P〈0．053。治疗组慢性重型乙肝早、中、晚期患者有较好疗效，血ET含量（kEU／L）均明显低于对照组（早期：0．097土0．015比0．109士0．038，中期：0．102±0．019比0．146±0．062，晚期：0．124±0．022比0．196±0．074，均P〈0．05）。结论肠毒清颗粒可改善慢性重型乙肝肠源性内毒素血症患者的肝功能和凝血功能，降低血清ET，改善临床症状。
Objective To investigate the therapeutic effect of enterotoxin clearance granule （肠毒清颗粒） for treatment of enterogenous endotoxemia in patients with chronic severe hepatitis B. Methods Ninety- six patients with chronic severe hepatitis B combined with enterogenous endotoxemia were divided randomly into treatment group （48 cases） and control group （48 cases）. Both groups received the combined therapy. Additionally, in the treatment group, enterotoxin clearance granule [composition： Ginseng （人参） 10 g, Magnolia （厚朴） 6 g, Rhubarb （大黄） 6 g, Citrus aurantium （枳实） 6 g, Red peony （赤芍） 10 g] was given orally, twice a day. The therapeutic course in both groups was 4 weeks. The clinical efficacy, improvement of clinical symptoms, changes of liver function, coagulation parameters and serum endotoxin levels before and after treatment were investigated in the two groups. Results The total effective rate in treatment group was significantly higher than that in control group （62.50% vs. 45.83%）, and the mortality was obviously lower than that in control group （14.58% vs. 33.33%, both P〈0.05）. After treatment, the clinical symptoms were obviously improved in both groups; in the treatment group, the scores of fatigue and abdominal distension were markedly lower than those in the control group （fatigue： 3.31± 0.22 vs. 6.42 ± 0.77, abdominal distension： 3.15 ± 0. 21 vs. 6.44±0. 62, both P〈0.05）. After treatment, the total bilirubin （TBil） level was decreased significantly, liver and blood coagulative functions were improved and prothrombin activity （PA） was increased in both groups; the improvement of TBil and PA in the treatment group was better than that in the control group [TBil （μmol/L）：94.6±52.3 vs. 124.6±64.4, PA： （52.8±11.5）% vs. （44.4± 10.2）%, both P〈0. 05]. In the treatment group, the patients at any stage, early, middle or late, all had a good therapeutic effect, and the blood endotoxin levels （kEU/L） were significantly lower than those in the control group （early stage： 0.097±0.015 vs. 0.109±0.038, medium： 0.102±0.019 vs. 0.146±0.062, later： 0.124±0.022 vs. 0.196±0.074, all P〈0.05）. Conclusion Enterotoxin clearance granule can improve the liver function and blood coagulative function, lower serum endotoxin level and improve clinical symptoms in patients with chronic severe hepatitis B combined with severe enterogenous endetoxemia.
出处
《中国中西医结合急救杂志》
CAS
北大核心
2011年第2期94-96,共3页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
河南省科技厅科技攻关项目（0496060401）
关键词
乙型肝炎
重型
慢性
内毒素血症
肠源性
肠毒清颗粒
Hepatitis B, severe, chronic
Endotoxemia, enterogenous
Enterotoxin clearance granule
