文献类型：期刊文献

中文题名：大承气汤保留灌肠治疗乙型肝炎病毒相关慢加急性肝衰竭肠源性内毒素血症患者的疗效

英文题名：The therapeutic effect of Dachengqi decoction retention enema on HBV-ACLF-IETM patients

作者：苏海霞[1];杨正茂[1];周渐[1];付兆媛[2];杨晓庆[1];王兆勋[1];魏晋红[1];邹嘉颖[1]

第一作者：苏海霞

机构：[1]兰州市第二人民医院感染科/肝病一科,甘肃兰州730000;[2]甘肃中医药大学附属医院

第一机构：兰州市第二人民医院感染科/肝病一科,甘肃兰州730000

年份：2025

卷号：35

期号：6

起止页码：689

中文期刊名：中西医结合肝病杂志

外文期刊名：Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基金：2024年度“人工肝专项基金”(No.iGandanF-1082024-RGG070)。

语种：中文

中文关键词：大承气汤;慢加急性肝衰竭;肠源性内毒素血症

外文关键词：Dachengqi decoction;chronic and acute liver failure;intestinal endotoxemia

摘要：目的:观察大承气汤保留灌肠辅助治疗乙型肝炎病毒相关慢加急性肝衰竭肠源性内毒素血症(HBV-ACLF-IETM)的临床疗效。方法:将60例HBV-ACLF-IETM患者按照随机数字表法随机分为2组,每组30例。在常规治疗基础上,治疗组给予大承气汤保留灌肠治疗,对照组给予乳果糖口服液保留灌肠,两组疗程均为4周。观察两组患者治疗前后肝功能、凝血酶原活动度(PTA)、内毒素(ET)、血氨,ELISA法检测血清白细胞介素-6(IL-6),肿瘤坏死因子α(TNF-α),采用终末期肝病模型(MELD)评分预测患者的病死率。结果:治疗后,治疗组的总有效率高于对照组(P<0.01)。两组患者的肝功能指标、PTA、ET、血氨、IL-6、TNF-α以及MELD评分均有所改善(P<0.01),且治疗组的改善更为显著(P<0.01)。结论:大承气汤保留灌肠治疗HBV-ACLF-IETM,可通过改善肝功能、降低血清炎性因子、降低内毒素水平,从而提高治疗总有效率,疗效明确。
Objective:To observe the clinical efficacy of Dachengqi decoction retention enema as an adjuvant therapy for enterogenous endotoxemia associated with hepatitis B virus associated chronic and acute liver failure(HBV-ACLF-IETM).Methods:Sixty patients with HBV-ACLF-IETM were randomly divided into two groups using a random number table,with 30 patients in each group.On the basis of conventional treatment,the treatment group was treated with Dachengqi decoction retention enema,while the control group was treated with lactulose oral solution retention enema.Both groups were treated for 4 weeks.Observe the liver function,prothrombin activity(PTA),endotoxin(ET),blood ammonia,and ELISA detection of serum interleukin-6(IL-6)and tumor necrosis factor alpha(TNF-α)before and after treatment in two groups.Use MELD score to predict the mortality rate of patients.Results:After treatment,the total effective rate in the treatment group was higher than that in the control group(P<0.01).The liver function indicators,PTA,ET,blood ammonia,IL-6,TNF-α,and MELD scores of patients in both groups were improved(P<0.01),and the improvement in the treatment group was more significant(P<0.01).Conclusion:Dachengqi decoction retention enema treatment for HBV-ACLF-IETM can improve liver function,reduce serum inflammatory factors,and lower endotoxin levels,thereby improving the overall treatment efficacy and achieving clear therapeutic effects.