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目的:观察益气疏肝、醒脾化湿通络法治疗慢性乙肝肝衰竭的疗效。方法:采用随机对照临床研究方法,将47例慢性乙肝肝衰竭患者随机分入中西医结合组和西医组,西医组采用西医综合治疗和人工肝治疗,中西医结合组在西医综合治疗和人工肝治疗基础上加用中药汤剂肝脾疏络饮口服,治疗8周后比较两组病死率、并发症发生率、人工肝次数、总体疗效和中医证候积分。结果:治疗8周后中西医结合组病死率低于西医组(12.5%VS 21.7%,P=0.461);中西医结合组原发性腹膜炎的发生率明显低于西医组(16.7%VS 43.5%,P=0.045),肝性脑病、肝肾综合征、消化道出血及电解质紊乱的发生率均略低于西医组;总体疗效中西医结合组优于西医组(83.3%VS 65.2%,P=0.193);治疗后中西医结合组中医证候积分低于西医组(11.35±3.91 VS 18.06±5.01,P=0.000)。结论:中西医结合治疗肝衰竭可以降低病死率、降低并发症发生率、有效改善临床症状、提高临床疗效,值得进一步研究和临床推广应用。
Objective: To observe the curative effect of Yiqi Shugan, Xingpi dampness and meridian method on chronic hepatitis B liver failure. Methods: A randomized controlled clinical trial was conducted in 47 patients with chronic hepatitis B liver failure. The patients were randomly divided into TCM combined group and western medicine group. Western medicine group was treated with western medicine combined with artificial liver. Western medicine combination group and western medicine combined with artificial liver After treatment for 8 weeks, the mortality, the incidence of complications, the number of artificial liver, the overall curative effect and TCM syndrome score were compared. Results: After 8 weeks of treatment, the incidence of primary peritonitis in the combination of traditional Chinese and western medicine was significantly lower than that in the Western medicine group (12.5% vs 21.7%, P = 0.461) = 0.045). The incidence of hepatic encephalopathy, hepatorenal syndrome, gastrointestinal bleeding and electrolyte disturbances were all slightly lower than that of Western medicine group. The overall effect was better than western medicine group (83.3% VS 65.2%, P = 0.193) After treatment, the score of TCM syndrome in traditional Chinese and western medicine group was lower than that in Western medicine group (11.35 ± 3.91 vs 18.06 ± 5.01, P = 0.000). Conclusion: Integrative treatment of liver failure can reduce mortality, reduce the incidence of complications, effectively improve clinical symptoms and improve clinical efficacy, it is worth further study and clinical application.