CAJ | 학술논문

目的回顾性分析淤胆汤治疗急性淤胆型肝炎的临床疗效。方法选取本院2009年1月至2011年12月诊断为急性淤胆型肝炎的住院患者86例，根据治疗中是否应用中药“淤胆汤”分为单纯西药治疗组（A组，45例）和西药联合淤胆汤治疗组（B组，41例），观察治疗后8周两组中医症候评分，生化学指标改善情况和治疗有效率。结果A、B两组患者中医症候评分下降分别为（26.99±2.02）分和（28.13±2.37）分，TBil下降中位数分别为242.45μmol/L和312.65μmol/L，GGT下降中位数分别为57.00 U/L和116.50 U/L，ALP下降中位数分别为68 U/L和91 U/L，TBA下降中位数分别为170.50μmol/L和191.50μmol/L，总有效率分别为80.00%和95.12%，差异有统计学意义（P=0.032、0.036）。A、B两组患者ALT下降中位数分别为645.50 U/L和613.25 U/L，差异无统计学意义（P=0.0897）。结论西药联合淤胆汤治疗急性淤胆型肝炎对中医症候积分的改善、生物化学指标的改善及有效率等方面优于纯西药治疗组。中医辩证施治，凉血活血、清热化湿法在治疗急性淤胆型肝炎方面值得积极推广。
목적회고성분석어담탕치료급성어담형간염적림상료효。방법선취본원2009년1월지2011년12월진단위급성어담형간염적주원환자86례，근거치료중시부응용중약“어담탕”분위단순서약치료조（A조，45례）화서약연합어담탕치료조（B조，41례），관찰치료후8주량조중의증후평분，생화학지표개선정황화치료유효솔。결과A、B량조환자중의증후평분하강분별위（26.99±2.02）분화（28.13±2.37）분，TBil하강중위수분별위242.45μmol/L화312.65μmol/L，GGT하강중위수분별위57.00 U/L화116.50 U/L，ALP하강중위수분별위68 U/L화91 U/L，TBA하강중위수분별위170.50μmol/L화191.50μmol/L，총유효솔분별위80.00%화95.12%，차이유통계학의의（P=0.032、0.036）。A、B량조환자ALT하강중위수분별위645.50 U/L화613.25 U/L，차이무통계학의의（P=0.0897）。결론서약연합어담탕치료급성어담형간염대중의증후적분적개선、생물화학지표적개선급유효솔등방면우우순서약치료조。중의변증시치，량혈활혈、청열화습법재치료급성어담형간염방면치득적겁추엄。
Objective To evaluate the effect of herbal remedy Yudan Decoction on treatment of acute cholestatic hepatitis. Methods Total of 86 patients with acute cholestatic hepatitis hospitalized from January 2009 to December 2011 in our hospital were selected and grouped into group A (45 cases with Western medical treatment only) and group B (41 cases with combined treatment of Western medicine and Yudan Decoction) randomly. After 8 weeks of treatment, the indexes of biochemistry, the score of traditional Chinese Medical Signs, the peak duration of jaundice and the treatment efifcacy rate were compared between the two groups. Results In group A and group B, the declination of score of Traditional Chinese Medical Signs were (26.99 ± 2.02) and (28.13 ± 2.37), respectively;the median of reduction of TBil were 242.45μmol/L and 312.65μmol/L, respectively;the median of reduction of GGT were 57.00 U/L and 116.50 U/L, respectively;the median of reduction of ALP were 68 U/L and 91 U/L, respectively;the median of reduction of TBA were 170.50μmol/L and 191.50μmol/L, respectively;the efifcacy rate were 80.00%and 95.12%, respectively, all with statistical signiifcance (P=0.032, 0.036). The median of reduction of ALT were 645.50 U/L and 613.25 U/L, respectively, without statistical difference (P=0.897). Conclusions The treatment on patients with acute cholestatic hepatitis using the combination of Western medicine and Yudan Decoction is more effective than Western medicine alone, with declining of the score of Traditional Chinese Medical Signs, alleviating the biochemistry indexes and increasing the effectiveness rate. The dialectic method of Traditional Chinese Medicine in cooling down and reactivating the blood, dispelling the toxic heat and dissolving the dampness is worth promoting in the clinical treatment of acute cholestatic hepatitis.