资源描述:
《肝脑清肠汤治疗肝性脑病的临床对照研究1》由会员上传分享,免费在线阅读,更多相关内容在工程资料-天天文库。
1、中文摘要目的:在常规药物综合治疗的基础上,采用肝脑清肠汤结肠灌洗结合保留灌肠治疗肝性脑病,经与单用西药灌肠方法进行疗效比较,观察肝脑清肠汤对肝性脑病的治疗及预防效杲。方法:50例肝性脑病患者随机分为两组。治疗组25例采用在常规药物综合治疗的基础上,采用结肠灌洗结合中药保留灌肠治疗;对照组25例采用结肠灌洗结合白醋保留灌肠治疗。检测两组治疗前后血清肝功能、血氨等生化指标,观察患者临床症状和体征的改善情况及其预后。比较対组的治疗效果。分别于治疗前后测定:血氨(NH3)、肝功能指标,包括丙氨酸氨基转移酶(ALT)、天冬氨酸转移酶(AST)和血清总胆红素(SB),
2、以及门蛋口(ALB)、总胆固醇(TC)、凝血卿原时间(PT),对临床疗效和不良反应进行评价。结果:治疗组降低血氨优于对照组(P<0.05),;治疗组肝功能(ALT、AST、SB)的改善优于对照组(P<0.05);各组治疗后血浆胆固醇均有轻度升高(P<0.05),但两组间比校无统计学魁异(P>0.05);各组治疗后凝血酶原时间(PT)均有所缩短(PV0.05),以治疗组缩短明显,但两组间比较无统计学差界(P>0.05);各组治疗后ALB均略有提高,但仅治疗组治疗前后比较有统计学差异(P<0.05),两组间比较亦无统计学差异(P>0.05);纠正血气异常(主要
3、是代谢性碱屮毒)治疗组优于对照组(PV0.05);治疗组治疗总有效率高于对照组。结论:肝脑清肠汤可显著降低肝性脑病的血氨水平,能明显改善肝功能(ALT、AST、SB)的异常,治疗组优于对照组。同时肝脑清肠汤可在一定程度上改善患者白蛋白、胆固醇及凝血功能的异常,临床疗效确切,用药安全,不良反应少。关键词:肝脑清肠汤肝硬化肝性脑病治疗AbstractObjective:ToevaluatetheeffectandsafetyofL-ornithine-L-aspartateonC-TypeHepaticEncephalopathy.Methode:Inthis
4、randomizedcontrolledclinicalstudy,90patientswithC-TypeHepaticEncephalopathyandterminalHepaticCirrhosis(Child-PughC)randomizedintothreegroups:30patientsreceivedL-omithine-L-aspartate(OA)atthedoseof20gperdayforoneweek(theHTgroup);30patientsreceivedOAlOgperdayforoneweek(theLTgroup),a
5、ndtheother30patientsreceivedArginine20gperdayforoneweekasthecontrolgroup.Bothofthethreegroupsreceivedthesamefundamentaltherapyincludeslimitedtheproteinintaken,Vitaminandnutritionsupporting,Lactuloseoraladministrationandacidationtheintestinal.TheeffectiveandsideeffectsofOAwereevalu
6、atedbythechangeofPortal-systemEncephalopathyIndex(PSEI);plasmaamonia(NH3);HepaticFunctionindexesincludingalanineaminotransferase(ALT),aspartateaminotransferase(AST),serumbilirubin(SB),andAlbumin(ALB);totalcholesterol(TC);plasmathromboplastin(PT)andPHporeandafterthetreatments.Theef
7、ficiencyofthetreatmentswereevaluatedeither.Results:TherewasmoresignificantdifferenceofNH3,andthetotalefficiencybetweentheHT,LTandthecontrolgroup;therewasalsomoresignificantdifferenceofALT,ASTandSBbetweenHTandtheothergroups;eachgroupshassomechangeofALB,TC,PT,afterthetreatments,theH
8、Tgrouphasasignificantdifferencean