[1]孙绿铭,方 荣,顾 贤,等.地黄饮子联合乳果糖治疗轻微型肝性脑病疗效及对患者血氨、内毒素的影响[J].陕西中医,2022,(2):177-180.[doi:DOI:10.3969/j.issn.1000-7369.2022.02.008]
 SUN Lyuming,FANG Rong,GU Xian,et al.Efficacy of Dihuang Yinzi combined with lactulose in the treatment of mild hepatic encephalopathy and its effect on blood ammonia and endotoxin levels[J].,2022,(2):177-180.[doi:DOI:10.3969/j.issn.1000-7369.2022.02.008]
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地黄饮子联合乳果糖治疗轻微型肝性脑病疗效及对患者血氨、内毒素的影响
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2022年2期
页码:
177-180
栏目:
临床研究
出版日期:
2022-02-05

文章信息/Info

Title:
Efficacy of Dihuang Yinzi combined with lactulose in the treatment of mild hepatic encephalopathy and its effect on blood ammonia and endotoxin levels
作者:
孙绿铭1方 荣1顾 贤2王又闻2
(1.上海中医药大学附属曙光医院急诊科,上海 201203; 2.上海中医药大学中药学院,上海 200032)
Author(s):
SUN LyumingFANG RongGU XianWANG Youwen
(Department of Emergency,Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)
关键词:
轻微型肝性脑病 地黄饮子 乳果糖 血氨 内毒素
Keywords:
Mild hepatic encephalopathy Dihuang Yinzi Lactulose Blood ammonia Endotoxin
分类号:
R 575.2
DOI:
DOI:10.3969/j.issn.1000-7369.2022.02.008
文献标志码:
A
摘要:
目的:探讨地黄饮子联合乳果糖治疗轻微型肝性脑病(MHE)的疗效及对血氨、内毒素水平的影响。方法: 选取74例MHE患者,采用随机数字表法分为对照组(乳果糖治疗)和联合组(地黄饮子加乳果糖治疗),每组各37例。比较两组患者治疗前后肝性脑病数字连接试验(NCT)时间、数字符号试验(DST)评分、肝功能指标、血氨及内毒素水平; 比较两组患者临床疗效; 比较两组患者治疗期间不良反应。结果: 治疗前两组患者NCT时间、DST评分比较,差异均无统计学意义(P>0.05); 治疗后两组患者NCT时间均降低(P<0.05),且联合组NCT时间低于对照组(P<0.05); 治疗后两组患者DST评分均升高(P<0.05),且联合组DST评分高于对照组(P<0.05)。治疗前两组患者总胆红素(TSB)、天冬氨酸氨基转移酶(AST)及丙氨酸氨基转移酶(ALT)水平比较,差异均无统计学意义(P>0.05); 治疗后两组患者TSB、AST及ALT水平均降低(P<0.05),且联合组TSB、AST及ALT水平均低于对照组(P<0.05)。治疗前两组患者血氨、内毒素水平比较,差异均无统计学意义(P>0.05); 治疗后两组患者血氨、内毒素水平均降低(P<0.05),且联合组血氨、内毒素水平均低于对照组(P<0.05)。两组患者临床疗效比较,差异具有统计学意义(P<0.05),且联合组总有效率高于对照组(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论: 采用地黄饮子联合乳果糖治疗MHE患者可提高患者的认知功能、改善肝功能,降低血氨、内毒素水平,提高临床疗效。
Abstract:
Objective:To explore the curative effect of Dihuang Yinzi combined with lactulose in the treatment of mild hepatic encephalopathy(MHE)and its effect on blood ammonia and endotoxin levels.Methods:A total of 74 MHE patients were selected and divided into a control group(Lactulose treatment)and a combination group(Dihuang Yinzi combined with lactulose)using a random number table,with 37 cases in each group.Patients in both groups were compared before and after treatment in the aspects of the number connection test(NCT)time for the assessment of hepatic encephalopathy,digital sign test(DST)score,liver function indicators,blood ammonia and endotoxin levels.Further comparison was made focusing on the clinical efficacy of the two groups of patients.In addition,the adverse reactions of the two groups of patients were compared during treatment.Results:Before treatment,there was no statistically significant difference in NCT time and DST score between the two groups of patients(P>0.05).After treatment,the NCT time of the two groups of patients was reduced(P<0.05),and it in the combination group was lower than that of the control group(P<0.05).After treatment,the DST scores of the two groups were increased(P<0.05),and it in the combination group was higher than that of the control group(P<0.05).Before treatment,there was no significant difference in the levels of total serum bilirubin(TSB),aspartate aminotransferase(AST)and alanine aminotransferase(ALT)between the two groups of patients(P>0.05).After treatment,the levels of TSB,AST and ALT of the two groups of patients were decreased(P<0.05),which were lower in the the combination group than those of the control group(P<0.05).Before treatment,there was no significant difference in blood ammonia and endotoxin levels between the two groups of patients(P>0.05).After treatment,the blood ammonia and endotoxin levels of the two groups were reduced(P<0.05),both of which were lower in the combined group than those of the control group(P<0.05).There was a significant difference in the distribution of clinical efficacy between the two groups(P<0.05),and the total effective rate of the combination group was higher than that of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups of patients(P>0.05).Conclusion:The treatment of MHE patients with Dihuang Yinzi combined with lactulose can enhance patients' cognitive function and liver function,reduce blood ammonia and endotoxin levels,and improve clinical efficacy.

参考文献/References:

[1] Gonzalez RA,Higuera LT,Moreno AR,et al.Pathophysiology of hepatic encephalopathy and future treatment options[J].Rev Gastroenterol Mex(Engl Ed),2019,84(2):195-203.
[2] Bajaj JS,Duarte RA,Xie JJ,et al.Minimal hepatic encephalopathy and mild cognitive impairment worsen quality of life in elderly patients with cirrhosis[J].Clin Gastroenterol Hepatol,2020,18(13):3008-3016.
[3] 罗 莎,周治明,郭大静,等.轻微型肝性脑病患者静息态下双侧楔前叶与全脑其他区域功能连接变化[J].中国医学影像技术,2019,35(3):321-325.
[4] 张 哲,魏 延,韩 伟,等.乳果糖联合益生菌治疗轻微型肝性脑病的Meta分析[J].胃肠病学和肝病学杂志,2021,30(1):95-101.
[5] 李晶滢,李 丽.地黄饮子治疗轻微型肝性脑病的临床疗效分析[J].中西医结合肝病杂志,2019,29(1):19-20.
[6] 郑洪娥,袁广梅,王子江,等.实用急症内科[M].北京:科学技术文献出版社,2012:26-27.
[7] 国家食品药品监督管理总局.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:143-150.
[8] 王雨丽,邵丽春,杨 卓.数字连接试验对轻微肝性脑病诊断价值及肝硬化并发肝性脑病相关因素分析[J].临床军医杂志,2020,48(12):40-42,45.
[9] 郝良成,胡阳黔,侯晓华.年龄和受教育程度矫正的数字连接测试和数字符号测试在诊断轻肝性脑病中的应用[J].中华肝脏病杂志,2015,23(7):533-537.
[10] 郑 岳,杨丽敏,王晋升.瞬时肝弹性测定技术评价替比夫定治疗乙肝早期肝硬化疗效研究[J].陕西医学杂志,2018,47(12):1595-1598.
[11] 中华医学会消化病学分会,中华医学会肝病学分会.中国肝性脑病诊治共识意见(2013年,重庆)[J].中华肝脏病杂志,2013,21(9):641-651.
[12] Zhang G,Li Y,Zhang X,et al.Identifying mild hepatic encephalopathy based on multi-layer modular algorithm and machine learning[J].Front Neurosci,2020,14(6):62-65.
[13] Rubio T,Felipo V,Tarazona S,et al.Multi-omic analysis unveils biological pathways in peripheral immune system associated to minimal hepatic encephalopathy appearance in cirrhotic patients[J].Sci Rep,2021,11(1):1907-1912.
[14] 董树云,李 健.乳果糖联合乳酸菌素治疗轻微型肝性脑病临床观察[J].中国实用神经疾病杂志,2017,20(13):71-73.
[15] 蒋海南,毛德文,叶倩伶,等.中医辨证论治肝性脑病研究进展[J].陕西中医,2020,41(11):1268-1270.
[16] 覃 辉,周城恩,陆 晖,等.地黄饮子方结合胞磷胆碱治疗血管性痴呆肾精亏虚兼痰瘀阻络证疗效及对血清β-AP、E2、Livin水平的影响[J].现代中西医结合杂志,2019,28(6):589-592.
[17] 李 东.有益菌、乳果糖口服溶液在轻微肝性脑病治疗中的疗效观察[J].中国社区医师,2019,35(6):30,32.
[18] 李小侠.血清谷氨酸脱氢酶与其他肝功能指标联合检测在肝病诊断中的临床意义[J].陕西医学杂志,2020,49(2):143-146.
[19] 李 洁,赵江明,王 黎,等.轻微型肝性脑病发病机制的研究进展[J].山东医药,2019,59(35):103-105.
[20] 张勤俭.和肝散对代偿性肝硬化的疗效及HA、LN、PCⅢ水平作用分析[J].陕西中医,2018,39(5):568-570.

备注/Memo

备注/Memo:
基金项目:上海市卫生和计划生育委员会科技项目(20184Y0246)
更新日期/Last Update: 2022-02-09