人工肝联合凉血解毒化瘀方治疗重型乙肝疗效观察

李守娟，王丽*，胡朝霞，王磊，吴蓓，段萌，朱丽，李筠

（1.四川省成都市公共卫生临床医疗中心，四川成都610066；2.中国人民解放军第302医院，北京100039）

人工肝联合凉血解毒化瘀方治疗重型乙肝疗效观察

李守娟1，王丽1*，胡朝霞1，王磊1，吴蓓1，段萌1，朱丽1，李筠2

（1.四川省成都市公共卫生临床医疗中心，四川成都610066；2.中国人民解放军第302医院，北京100039）

目的评价人工肝支持系统联合中药凉血解毒化瘀方治疗慢性乙型重型肝炎的疗效。方法根据患者病情采用本院开展的不同模式人工肝支持系统（血浆置换联合血浆灌流、胆红素吸附联合血浆置换、双重血浆吸附联合血浆置换、分子吸附再循环）联合凉血解毒化瘀方治疗46例慢性乙型重型肝炎，30例对照组仅给予基础疗法加人工肝支持系统治疗。结果两组患者治疗后临床症状、肝功能、凝血酶原活动度、血氨明显改善，治疗组优于对照组（P＜0.05）。治疗组46例患者中临床治愈9例，显效25例，有效6例，无效3例，死亡3例，总有效率86.96%，优于对照组，随访半年存活率与对照组有统计学意义（P＜0.05）。结论人工肝支持系统是治疗慢性乙型重型肝炎的有效手段，联合凉血解毒化瘀方中西医结合疗法可提高临床疗效，降低患者病死率。

人工肝支持系统；重型乙肝；中西医结合治疗；凉血解毒化瘀方

〔Abstract〕Objective To evaluate of artificial liver support system combined with TCM Liangxue Jiedu Huayu Fang on chronic severe hepatitis B.M ethods According to the different patterns of patients using in our hospital to carry out artificial liver support system（plasma perfusion plasmapheresis，joint plasma exchange，double plasma bilirubin adsorption joint plasma exchange adsorption，molecular adsorption recycling）combined with Liangxue Jiedu Huayu Fang to treat 46 cases of chronic severe hepatitis B，and another 30 patients as control group were treated with basic therapy add artificial liver support system.Results After treatment，the clinical symptoms，liver function，prothrombin activity（PTA），blood ammonia of two groups were obviously improved，the treatment group was significantly better than the control group（P＜0.05）.The result of 46 patients in the treatment group was as follow：cured effect in 9 cases，obvious effect in 25 cases，effect in 6 cases，no effect in 3 cases，died in 3 cases，and the total efficiency was 86.96%，which is better than the control group.After following up for half a year，the survival rate was higher than the control group（P＜0.05）.Conclusion Artificial liver support system is an effective method for the treatment of chronic severe hepatitis B，which combined with Liangxue Jiedu Huayu Fang can improve the clinical curative effect，and reduce themortality of patient.

〔Keywords〕artificial liver support system；severe hepatitis B；combined treatment of TCM and Western medicine；Liangxue Jiedu Huayu Fang

重型肝炎是多种致病因素作用于机体导致肝脏发生大块或亚大块坏死所致的肝功能衰竭，由于其起病急骤，病情进展迅速，易发生出血、感染、继发性肾功损害等严重并发症，死亡率高达50%～60%［1］。……