CAJ | 학술논문

目的：评价糖皮质激素联合茵栀黄注射液治疗重症酒精性肝炎的疗效。方法：采用回顾性调查分析2009年1月至2014年1月期间接受治疗的40例重症酒精性肝炎患者，随机分为治疗组与对照组各20例，对照组给予戒酒、营养支持及常规内科综合治疗；治疗组予上述治疗，同时给予甲基强的松龙（1 mg? kg? d-1）静脉滴注，定期减量，疗程满28 d，联合茵栀黄注射液30 mL 加入10％葡萄糖注射液250 mL 中静脉滴注。检测两组患者治疗基线及28 d 后的肝功能、凝血功能，评估基线马德里判别函数（MDF）等，比较两组患者生存率和并发症。结果：治疗28 d 后治疗组总胆红素（TBIL）、凝血酶原时间（PT）、血清白蛋白（ALB）、天冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）分别为（43．56±18．84）μmol? L-1、（14．02±2．40）sec、（36．32±6．39） g? L-1、（52．04±30．09） U? L-1、（44．51±28．47） U? L-1，分别优于对照组（72．19±32．55）μmol? L-1、（18．63±4．77）sec、（31．20±3．19） g? L-1、（116．18±85．33） U? L-1、（99．27±53．11） U? L-1，P 值均＜0．01。28 d 生存率治疗组为85％、对照组为50％（P ＜0．05）。并发症发生率治疗组为10％，对照组为45％（P ＜0．05）。结论：糖皮质激素联合茵栀黄注射液治疗重症酒精性肝炎，可明显改善肝功能，减少并发症，提高患者生存率。
목적：평개당피질격소연합인치황주사액치료중증주정성간염적료효。방법：채용회고성조사분석2009년1월지2014년1월기간접수치료적40례중증주정성간염환자，수궤분위치료조여대조조각20례，대조조급여계주、영양지지급상규내과종합치료；치료조여상술치료，동시급여갑기강적송룡（1 mg? kg? d-1）정맥적주，정기감량，료정만28 d，연합인치황주사액30 mL 가입10％포도당주사액250 mL 중정맥적주。검측량조환자치료기선급28 d 후적간공능、응혈공능，평고기선마덕리판별함수（MDF）등，비교량조환자생존솔화병발증。결과：치료28 d 후치료조총담홍소（TBIL）、응혈매원시간（PT）、혈청백단백（ALB）、천동안산안기전이매（AST）、병안산안기전이매（ALT）분별위（43．56±18．84）μmol? L-1、（14．02±2．40）sec、（36．32±6．39） g? L-1、（52．04±30．09） U? L-1、（44．51±28．47） U? L-1，분별우우대조조（72．19±32．55）μmol? L-1、（18．63±4．77）sec、（31．20±3．19） g? L-1、（116．18±85．33） U? L-1、（99．27±53．11） U? L-1，P 치균＜0．01。28 d 생존솔치료조위85％、대조조위50％（P ＜0．05）。병발증발생솔치료조위10％，대조조위45％（P ＜0．05）。결론：당피질격소연합인치황주사액치료중증주정성간염，가명현개선간공능，감소병발증，제고환자생존솔。
Objective:To evaluate the curative effect on glucocorticoid and yinzhihuang injection in severe alcoholic hepatitis.Methods:40 patients with severe alcoholic hepatitis were selected, who were tread from January 2009 to January 2014, and a retrospective analysis was performe, patients were divided into 2 groups.The control group (20 cases) who were treated with quit drinking, correct malnutrition and general medical treatment;the treatment group (20 cases) who were treated with methyl-prednisone(1 mg? kg? d-1 ) on the basis of the control group, periodic reduction, and joint yinzhihuang injection 30 mL in 10% glucose injection intravenous drip in 250 mL.The two groups were treated for 28 d.The liver function, blood coagulation of the two groups in baseline, on 28th day were detected, and the MDF scores of the patients of the two groups in baseline were calculated.The survival rate and complications of the two groups were esti-mated.Results: After 28 d, the levers of the total bilirubin, prothrombin time, serum albumin, AST and ALT in the treatment were (43.56 ±18.84) μmol? L-1 , (14.02 ±2.40) sec, (36.32 ±6.39) g? L-1 , (52.04 ±30.09) U? L-1 , (44.51 ±28.47) U?-1 , and the levers in control group were (72.19 ±32.55 ) μmol? L-1 , ( 18.63 ±4.77 ) sec, ( 31.20 ±3.19 ) g? L-1 ,-1 , (99.27 ±53.11) U? L-1 .There were significant differences between the two groups(P <0.01).The survival rate was 85% in treatment group and 50% in control group ( P <0.05) at the 28th day.The complication was 10% in treatment group, and 45% in control group ( P <0.05).Conclusion: The therapeutic effectiveness of glucocorticoid with yinzhi-huang injection are that they can improve liver functions of severe alcoholic hepatitis patients and improve survival rate, at the same time reduce the complications.