淤胆汤治疗急性淤胆型肝炎疗效观察

目的回顾性分析淤胆汤治疗急性淤胆型肝炎的临床疗效。方法选取本院2009年1月至2011年12月诊断为急性淤胆型肝炎的住院患者86例,根据治疗中是否应用中药"淤胆汤"分为单纯西药治疗组(A组,45例)和西药联合淤胆汤治疗组(B组,41例),观察治疗后8周两组中医症候评分,生化学指标改善情况和治疗有效率。结果 A、B两组患者中医症候评分下降分别为(26.99±2.02)分和(28.13±2.37)分,TBil下降中位数分别为242.45μmol/L和312.65μmol/L,GGT下降中位数分别为57.00 U/L和116.50 U/L,ALP下降中位数分别为68 U/L和91 U/L,TBA下降中位数分别为170.50μmol/L和191.50μmol/L,总有效率分别为80.00%和95.12%,差异有统计学意义(P=0.032、0.036)。A、B两组患者ALT下降中位数分别为645.50 U/L和613.25 U/L,差异无统计学意义(P=0.0897)。结论西药联合淤胆汤治疗急性淤胆型肝炎对中医症候积分的改善、生物化学指标的改善及有效率等方面优于纯西药治疗组。中医辩证施治,凉血活血、清热化湿法在治疗急性淤胆型肝炎方面值得积极推广。

Evaluation on herbal remedy Yudan Decoction on treatment of acute cholestatic hepatitis

Objective To evaluate the effect of herbal remedy Yudan Decoction on treatment of acute cholestatic hepatitis. Methods Total of 86 patients with acute cholestatic hepatitis hospitalized from January 2009 to December 2011 in our hospital were selected and grouped into group A （45 cases with Western medical treatment only） and group B （41 cases with combined treatment of Western medicine and Yudan Decoction） randomly. After 8 weeks of treatment, the indexes of biochemistry, the score of traditional Chinese Medical Signs, the peak duration of jaundice and the treatment efifcacy rate were compared between the two groups. Results In group A and group B, the declination of score of Traditional Chinese Medical Signs were （26.99 ± 2.02） and （28.13 ± 2.37）, respectively;the median of reduction of TBil were 242.45μmol/L and 312.65μmol/L, respectively;the median of reduction of GGT were 57.00 U/L and 116.50 U/L, respectively;the median of reduction of ALP were 68 U/L and 91 U/L, respectively;the median of reduction of TBA were 170.50μmol/L and 191.50μmol/L, respectively;the efifcacy rate were 80.00%and 95.12%, respectively, all with statistical signiifcance （P=0.032, 0.036）. The median of reduction of ALT were 645.50 U/L and 613.25 U/L, respectively, without statistical difference （P=0.897）. Conclusions The treatment on patients with acute cholestatic hepatitis using the combination of Western medicine and Yudan Decoction is more effective than Western medicine alone, with declining of the score of Traditional Chinese Medical Signs, alleviating the biochemistry indexes and increasing the effectiveness rate. The dialectic method of Traditional Chinese Medicine in cooling down and reactivating the blood, dispelling the toxic heat and dissolving the dampness is worth promoting in the clinical treatment of acute cholestatic hepatitis.