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目的:观察川芎嗪联合中药治疗胆道闭锁肝门空肠吻合(Kasa)i术后的临床疗效。方法:将40例胆道闭锁Kasai术后患儿分为治疗组和对照组各20例,对照组予西医基础治疗,治疗组在对照组治疗的基础上加用静脉滴注川芎嗪及口服健脾化湿、温阳活血中药,2组均以治疗2月为1疗程,观察患儿黄疸消退、肝功能指标、胆管炎发作次数及身高、体重、生活质量情况,以评价其临床疗效。结果:黄疸消退总有效率治疗组为85%,对照组为45%,2组比较,差异有显著性意义(P<0.05)。治疗后治疗组总胆红素(TBi)l、直接胆红素(DBi)l、胆汁酸(TBA)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、γ-谷氨酰转肽酶(γ-GT)、碱性磷酸酶(ALP)较治疗前均显著下降(P<0.01),且各指标治疗后均低于对照组(P<0.05);对照组仅TBil、AST2项指标较治疗前下降(P<0.05)。胆管炎平均发作次数治疗组为1.5次/人,对照组为3.2次/人,2组比较,差异有显著性意义(P<0.05)。2组患儿身高、体重、体重指数比较,差异均无显著性意义(P>0.05)。治疗组生活质量评价优于对照组,差异有显著性意义(P<0.05)。结论:川芎嗪联合健脾化湿、温阳活血中药治疗胆道闭锁Kasai术后患儿,可加快黄疸消退,改善肝功能,减少胆管炎发作次数,提高患儿的生活质量。
Objective: To observe the clinical efficacy of ligustrazine combined with traditional Chinese medicine in the treatment of biliary atresia with hepatic portal jejunostomy (Kasa) i. Methods: Forty children with biliary atresia after Kasai surgery were divided into treatment group and control group, 20 cases in each group. The control group was treated with western medicine. The treatment group was treated with intravenous infusion of ligustrazine and oral spleen Dampness, warming Yang and promoting blood circulation. Both groups were given a course of treatment for 2 months. The children’s jaundice subsided, the indexes of liver function, the number of cholangitis and the height, weight and quality of life were observed to evaluate the clinical effect. Results: The total effective rate of jaundice regression was 85% in the treatment group and 45% in the control group. There was significant difference between the two groups (P <0.05). After treatment, the total bilirubin (TBi) 1, DBi l, TBA, ALT, AST, γ-GT) and alkaline phosphatase (ALP) were significantly lower than those before treatment (P <0.01), and all indicators were lower than the control group after treatment (P <0.05) Before falling (P <0.05). The average number of cholangitis episodes was 1.5 times in the treatment group and 3.2 times in the control group. There was significant difference between the two groups (P <0.05). There were no significant differences in height, weight and body mass index between the two groups (P> 0.05). The quality of life of the treatment group was better than the control group, the difference was significant (P <0.05). Conclusion: Ligustrazine combined with invigorating the spleen and dampness and activating the yang and activating blood circulation to treat children with biliary atresia after Kasai can accelerate the regression of jaundice, improve liver function, reduce the frequency of cholangitis and improve the quality of life of children.