摘要
目的通过对228例慢性乙型重型肝炎中西医结合治疗的临床研究,探讨中西医结合治疗时机以及影响疗效的因素。方法所有病例均采用中西医结合治疗措施,包括保肝、退黄、抗病毒、对症支持及中医辨证治疗,总结不同分期的疗效,对影响其预后的因素进行统计分析。结果 228例慢性乙型重型肝炎患者中,治疗总有效率44.3%;其中早期有效率80.0%,中期有效率50.4%,晚期有效率仅为10.0%。总胆红素、胆碱酯酶、白蛋白、凝血酶原活动度、总胆固醇、并发症、病情分期等指标均是影响疗效的相关因素。结论慢性乙型重型肝炎治疗有效率低,缺乏特效的治疗手段。在早中期进行中西医结合治疗可取得较好疗效。采用中西医结合治疗策略,通过中药有效控制并发症,降低病死率,是重型肝炎中西医结合治疗的主要方向。
Objective To explore the proper time for treatment and factors influencing the effect of 228 cases of severe chronic hepatitis B treated with integrated traditional Chinese and western medicine.Methods All these cases were treated by routine integrated traditional Chinese and western medicine including hepatocytes-protection,jaundice-reducing,antivirus,supportive care and treatment through differentiation of syndromes by TCM.The effects of different stages and the related factors to the outcome were analysed.Results Among 228 cases of severe chronic hepatitis B,the total effective rate was 44.3%,the effective rate in patients at early stage reached 80.0%,the effective rates in patients at mid and late stages were 50.4% and 10.0% respectively,and the total rate of failure was 55.7%.The factors influenced the outcome included serum level of total bilirubin,cholinesterase,albumen,prothrombin activity,total cholesterol,complications and stages of the disease.Conclusion The effective rate of patients with severe chronic hepatitis B is low and there is no special therapy at present time.This study shows that integrated traditional Chinese and western medicine therapy can achieve good results for patients at early and mid stage.Therefore,it will be a promising choice for controlling complications and reducing the mortality by Chinese herbs combined with substantial therapy of western medicine.
出处
《临床和实验医学杂志》
2011年第12期889-890,892,共3页
Journal of Clinical and Experimental Medicine
基金
国家"十一五"传染病重大专项课题"慢性重型肝炎证候规律及中西医结合治疗方案研究"(2008ZX10005-007)
关键词
慢性乙型重型肝炎
中西医结合
疗效
Chronic severe hepatitis B
Integrated traditional and western medicine
Effection
