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目的观察利胆合剂对婴儿肝病综合征的临床疗效及其对炎症因子影响。方法 82例肝病综合征患儿随机分为试验组和对照组,每组41例。对照组患儿给予更昔洛韦抗病毒治疗,诱导期5 mg·kg~(-1),每天2次,连用14 d;维持期5mg·kg~(-1),每天1次,连用14 d。试验组患儿在此基础上加用利胆合剂口服或灌肠治疗,28 d为1个周期。比较2组患儿的临床疗效、巨细胞病毒免疫球蛋白M(CMV-IgM)转阴率、症状消失时间、肝功能指标、炎症因子变化水平和不良反应发生率。结果试验组患儿治疗有效率和CMV-IgM转阴率分别为92.7%和87.8%,显著高于对照组的75.6%和68.3%(P<0.05)。试验组黄疸消退天数、肝脾回缩天数显著低于对照组(P<0.05),但体重增长差异无统计学意义(P>0.05)。试验组患儿治疗后总胆红素、直接胆红素、丙氨酸氨基转移酶、总胆酸、γ-谷氨酰转肽酶水平均显著低于治疗前和对照组(P<0.05)。试验组患儿肿瘤坏死因子α和白细胞介素6水平分别为(206.7±48.6),(29.7±5.0)ng·L~(-1),显著优于对照组的(283.6±34),(38.9±3.1)ng·L~(-1)(P<0.05)。2组患儿不良反应发生率差异无统计学意义(P>0.05)。结论中西医结合治疗对婴儿肝病综合征临床疗效显著,通过减轻患儿炎症反应改善整体症状。
Objective To observe the clinical curative effect of Li-Dan mixture on infantile hepatosis syndrome and its influence on inflammatory factors. Methods 82 cases of children with hepatosis syndrome were randomly divided into experimental group and control group, 41 cases in each group. The control group was given ganciclovir antiviral therapy. The induction period was 5 mg · kg -1, twice daily for 14 days. The maintenance period was 5 mg · kg -1, once daily for 14 days. d. On the basis of this study, children in experimental group were treated with oral or enema treatment of Li Dan mixture, 28 days for one cycle. The clinical curative effect, cytomegalovirus immunoglobulin M (CMV-IgM) negative rate, symptom disappear time, liver function index, inflammatory factor change level and adverse reaction rate were compared between the two groups. Results The effective rate of treatment and the negative rate of CMV-IgM in the experimental group were 92.7% and 87.8%, which were significantly higher than those in the control group (75.6% vs 68.3%, P <0.05). The experimental group jaundice extinction days, liver and spleen retraction days was significantly lower than the control group (P <0.05), but no significant difference in body weight gain (P> 0.05). After treatment, the levels of total bilirubin, direct bilirubin, alanine aminotransferase, total bile acid and γ-glutamyl transpeptidase in the experimental group were significantly lower than those before treatment and in the control group (P <0.05) . The levels of tumor necrosis factor alpha and interleukin 6 in the experimental group were (206.7 ± 48.6) and (29.7 ± 5.0) ng · L -1, respectively, which were significantly higher than those in the control group (283.6 ± 34 and 38.9 ± 3.1) ng · L -1 (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusion Integrative Medicine has a significant clinical effect on infantile hepatopathy syndrome and improves the overall symptoms by relieving the inflammatory reaction in infants.