[1]周 琳,周晓玲,冯丽娟.加味茵陈术附汤联合双重血浆分子吸附系统与血浆置换治疗慢加急性肝衰竭临床研究[J].陕西中医,2023,(2):170-173.[doi:DOI:10.3969/j.issn.1000-7369.2023.02.007]
 ZHOU Lin,ZHOU Xiaoling,FENG Lijuan.Clinical research of Yinchen Zhufu decoction combined with dual plasma molecular adsorption system and plasma exchange in the treatment of chronic acute liver failure[J].,2023,(2):170-173.[doi:DOI:10.3969/j.issn.1000-7369.2023.02.007]
点击复制

加味茵陈术附汤联合双重血浆分子吸附系统与血浆置换治疗慢加急性肝衰竭临床研究
分享到:

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2023年2期
页码:
170-173
栏目:
临床研究
出版日期:
2023-02-05

文章信息/Info

Title:
Clinical research of Yinchen Zhufu decoction combined with dual plasma molecular adsorption system and plasma exchange in the treatment of chronic acute liver failure
作者:
周 琳周晓玲冯丽娟
(柳州市中医医院,广西 柳州 545001)
Author(s):
ZHOU LinZHOU XiaolingFENG Lijuan
(Liuzhou Hospital of Traditional Chinese Medicine,Liuzhou 545001,China)
关键词:
肝功能衰竭 茵陈术附汤 血浆置换 双重血浆分子吸附系统 凝血功能
Keywords:
Liver failure Yinchen Zhufu decoction Plasma exchange Dual plasma mole-cular adsorption system Coagulation function
分类号:
R 575.3
DOI:
DOI:10.3969/j.issn.1000-7369.2023.02.007
文献标志码:
A
摘要:
目的:探讨加味茵陈术附汤联合双重血浆分子吸附系统(DPMAS)与血浆置换(PE)治疗慢加急性肝衰竭(ACLF)的临床疗效及安全性。方法:将66例ACLF患者根据治疗方案分为治疗组和对照组,每组33例。治疗组在常规治疗基础上采用中药加味茵陈术附汤联合DPMAS+PE治疗,对照组采用DPMAS+PE治疗,治疗两周,并随访8周。观察两组ACLF患者治疗后的症候积分、肝功能、凝血功能、并发症及生存率,评估加味茵陈术附汤联合DPMAS+PE治疗ACLF的临床疗效。结果:治疗组总有效率为75.75%,显著高于对照组42.42%(P<0.05); 两组患者治疗后,中医症候积分、肝功能、凝血功能均较治疗前明显改善(P<0.05),且治疗组优于对照组(P<0.05)。统计两组并发症发生率,治疗组低于对照组,组间比较差异具有统计学意义(P<0.05); 8周生存率比较,治疗组高于对照组,差异具有统计学意义(P<0.05)。结论:加味茵陈术附汤联合DPMAS+PE治疗ACLF,可以有效改善ACLF患者肝功能、凝血功能,并减轻临床症状,提高治疗有效率及生存率。
Abstract:
Objective:To discussing the clinical efficacy and safety of modified Yinchen Zhufu decoction combined with double plasma adsorption(DPMAS)and plasma exchange(PE)in the treatment of acute-on-chronic liver failure(ACLF)by collecting data before and after treatment and conduct data research and analysis.Methods:According to the treatment plan,66 ACLF patients were divided into treatment group and control group,with 33 cases in each group.The two groups were treated on the basis of conventional treatment.The treatment group was treated with Yinchen Zhufu decoction combined with DPMAS+PE,and the control group was treated with DPMAS+PE.The treatment cycle was 2 weeks,and the follow-up was 8 weeks.Medical records were collected and statistically analyzed.The clinical efficacy,syndrome score,liver function,coagulation function,complications and survival rate of ACLF patients in the treatment group and the control group were compared to evaluate the clinical efficacy of modified Yinchen Zhufu decoction combined with DPMAS+PE in the treatment of ACLF.Results:The total effective rate of the treatment group was 75.75%,which was significantly higher than that of the control group(P<0.05).After treatment,TCM syndrome score,liver function and coagulation function were significantly improved in both groups compared with before treatment(P<0.05); and the treatment group was better than the control group(P<0.05).The incidence of complications in the treatment group was lower than that in the control group,and the comparison between the two groups was statistically significant(P<0.05).The 8-week survival rate in the treatment group was significantly higher than that in the control group(P<0.05).Conclusion:Yinchen Zhufu decoction combined with DPMAS+PE in the treatment of ACLF can effectively improve the liver function and coagulation function of ACLF patients,reduce clinical symptoms,and improve the treatment efficiency and survival rate.

参考文献/References:

[1] 宁更献,李 力,侯军良,等.慢加急性肝衰竭病因、临床特点与预后关系分析[J].河北医药,2017,39(2):214-216.
[2] Zhang J,Luo H,Han Y,et al.Sequential versus mono double plasma molecular adsorption system in acute-on-chronic liver failures:A propensity-score matched study[J].Int J Artif Organs,2022,45(1):5-13.
[3] Liu JF,Yuan ZM,Wang QW.Pluripotent stem cell-derived strategies to treat acute liver failure:Current status and future directions[J].Journal of Clinical and Translational Hepatology,2022,10(4):692-699.
[4] Larsen FS.Artificial liver support in acute and acute-on-chronic liver failure[J]. Curr Opin Crit Care,2019,25(2):187-191.
[5] Wang GF,Li YY,Shi R,et al.Yinchen zhufu decoction protects against alpha-naphthylisothiocyanate-induced acute cholestatic liver injury in mice by ameliorating disordered bile acid homeostasis and inhibiting inflammatory responses[J].J Ethno Pharmacol,2020,254:112672.
[6] Dai L,Gao X,Ye ZH,et al.The “traditional Chinese medicine regulating liver regeneration” treatment plan for reducing mortality of patients with hepatitis B-related liver failure based on real-world clinical data[J].Front Med,2021,15(3):495-505.
[7] 张荣臻,吕 超,王 娜,等.大黄、赤芍注射液对急性肝衰竭模型大鼠肝功能、肝再生指标的影响及机制研究[J].陕西医学杂志,2021,50(9):1043-1047.
[8] 李斌华,谢 青,闫雪华.乙型肝炎病毒相关肝衰竭中医用药规律研究进展[J].陕西中医,2022,43(4):538-540.
[9] 杨秀珍,王 蔚,张丽丽,等.中药联合人工肝血浆置换治疗肝衰竭的Meta分析[J].中西医结合肝病杂志,2019,29(5):443-445,451.
[10] 中华医学会感染病学分会肝衰竭与人工肝学组,中华医学会肝病学分会重型肝病与人工肝学组.肝衰竭诊治指南(2018年版)[J].临床肝胆病杂志,2019,35(1):38-44.
[11] 周仲瑛.中医内科学[M].北京:中国中医药出版社,2003:277-282.
[12] 国家食品药品监督管理总局.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:361-390.
[13] 中国中西医结合学会.慢加急性肝衰竭中西医结合诊疗专家共识[J].临床肝胆病杂志,2021,37(9):2045-2053.
[14] Moreau R,Gao B,Papp M,et al.Acute-on-chronic liver failure:A distinct clinical syndrome[J].J Hepatol,2021,75:27-35.
[15] 张荣臻,吕 超,石清兰,等.急性肝衰竭大鼠模型构建实验研究[J].陕西医学杂志,2021,50(3):268-271.
[16] Khanam A,Kottilil S.Acute-on-chronic liver failure:Pathophysiological mechanisms and management[J].Front Med(Lausanne),2021,8:752875.
[17] Kanjo A,Ocskay K,Gede N,et al.Efficacy and safety of liver support devices in acute and hyperacute liver failure:A systematic review and network meta-analysis[J]. Sci Rep,2021,11(1):4189.
[18] Olivo R,Guarrera JV,Poulos NT.Liver transplantation for acute liver failure[J]. Clin Liver Dis,2018,22(2):409-417.
[19] 王国凤,昝 斌,马越鸣.茵陈术附汤药效学与药动学研究进展[J].上海中医药大学学报,2020,34(5):90-95.
[20] 朱芳红,杨伟宁,李 锋.茵陈术附汤加减治疗肝衰竭并发难治性黄疸疗效研究[J].陕西中医,2021,42(3):304-307.

备注/Memo

备注/Memo:
基金项目:国家自然科学基金资助项目(81760855); 广西壮族自治区研究生教育创新计划资助项目(YCSY2020106); 广西壮族自治区柳州市科技重大项目(2018AF10503)
更新日期/Last Update: 2023-02-08