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目的:观察醒脑静注射液联合还原型谷胱甘肽治疗肝性脑病的临床疗效。方法:将符合病例入选标准的80例肝性脑病患者随机分为观察组、对照组各40例。两组患者均于入院后常规给予限制蛋白摄入、去除诱因、补充白蛋白、维持电解质紊乱等对症治疗。观察组同时给予醒脑静注射液20 mL+250 mL 5%葡萄糖注射液,gtt,1次/d;还原型谷胱甘肽0.6 g+250 mL生理盐水igtt,1次/d。两组均10 d为1个疗程,治疗2个疗程后评价疗效。结果:显效率观察组62.50%,对照组45.00%,两组差异显著(P<0.05)。总有效观察组95.00%,对照组80.00%,两组差异显著(P<0.05)。与治疗前比较,两组门冬酸氨氨基转移酶(AST),丙氨酸氨基转移酶(ALT),总胆红素(TBil),血氨水平显著下降(P<0.05),治疗后AST,ALT,TBil,血氨水平观察组分别为(143.93±75.41),(124.45±74.43)U.L-1,(155.92±71.21),(131.43±49.16)μmol·L-1,对照组分别为(113.75±70.58),(94.32±42.64)U.L-1,(117.31±61.23),(91.33±39.15)μmol·L-1,观察组改善强于对照组(P<0.05)。观察组发热、惊厥、意识障碍、脑膜刺激征、颅神经受累消失时间为(1.4±0.4),(0.9±0.4),(1.6±0.4),(1.7±0.6),(1.2±0.4)d,对照组为(4.5±2.5),(4.2±1.3),(5.2±0.6),(4.1±0.8),(3.8±0.4)d。观察组脑电图、脑脊液恢复正常时间、平均住院时间为(10.1±0.8),(6.1±0.6),(8.3±2.5)d,对照组为(12.2±1.8),(7.5±1.8),(14.2±2.9)d,均治疗组短于对照组(P<0.05)。结论:采用醒脑静联合还原型谷胱甘肽治疗肝性脑病临床疗效显著。
Objective: To observe the clinical effects of xingnaojing injection combined with reduced glutathione in the treatment of hepatic encephalopathy. Methods: Eighty patients with hepatic encephalopathy who met the criteria of the selected cases were randomly divided into observation group and control group with 40 cases each. Two groups of patients were routinely given restrictions on protein intake after admission, removal of incentives, albumin, electrolyte maintenance disorders such as symptomatic treatment. The observation group was given Xingnaojing injection 20 mL + 250 mL 5% glucose injection, gtt, 1 / d; reduced glutathione 0.6 g + 250 mL saline igtt, 1 / d. Two groups were 10 d for a course of treatment, evaluation of 2 courses of treatment efficacy. Results: The markedly effective rate was 62.50% in the observation group and 45.00% in the control group, with significant difference between the two groups (P <0.05). The total effective observation group 95.00%, 80.00% in the control group, significant difference between the two groups (P <0.05). Compared with those before treatment, AST, ALT, TBil, and ammonia in serum of two groups were significantly decreased (P <0.05). After treatment, AST (143.93 ± 75.41), (124.45 ± 74.43) UL-1, (155.92 ± 71.21) and (131.43 ± 49.16) μmol·L-1 in the observation group and 113.75 (94.32 ± 42.64) UL-1, (117.31 ± 61.23) and (91.33 ± 39.15) μmol·L-1, respectively. The improvement in the observation group was stronger than that in the control group (P <0.05). The disappearance time of cranial nerve involvement was (1.4 ± 0.4), (0.9 ± 0.4), (1.6 ± 0.4), (1.7 ± 0.6), (1.2 ± 0.4) d in observation group with fever, convulsion, disturbance of consciousness and meningeal irritation, The control group was (4.5 ± 2.5), (4.2 ± 1.3), (5.2 ± 0.6), (4.1 ± 0.8), (3.8 ± 0.4) d respectively. The average time of hospitalization was (10.1 ± 0.8), (6.1 ± 0.6) and (8.3 ± 2.5) days in the observation group and normal control group was (12.2 ± 1.8) and (7.5 ± 1.8) days respectively 14.2 ± 2.9) d, all of which were shorter than the control group (P <0.05). Conclusion: The therapeutic effect of Xingnaojing combined with reduced glutathione on hepatic encephalopathy is significant.