感染性疾病用药专栏
LI Zhiliang;WEI Jia;XIE Junqiang;CHONG Yutian
2004, 23(4): 229-0231.
TO appraise the therapeutic effectiveness of traditional Chinese medicines in the treatment of severe chronic viral hepatitis B. Methods:148 patients with severe chronic viral hepatitis B served as the subject of the study. Among these, 65 patients suffered from severe chronic viral hepatitis B, 29 cases of which received only conventional therapy while the other 36 were subjected to treatment with traditional Chinese medicines on the basis of the conventional therapy. 32 patients suffered from severe viral hepatitis B associated with hepatic failure. Of these, 18 patients had received decoction treatment longer than one week before admission, while the other 14 had not been treated with traditional Chinese medicines prior to admission. All these 32 patients were subjected to treatment with traditional Chinese medicines. The remaining 51 patients in the restoration stage of severe hepatitis associated with hepatic failure were discharged from our hospital from March 2000 to June 2002. Of these, 27 patients were treated with traditional Chinese medicines while the other 24 were not. For the treatment of chronic viral hepatitis B, the major traditional Chinese medicine was Oriental Wormwood Decoction modified by adding Capejasmine, rhubarb, elephantopus scaber, bupleurum root, Japanese St. Johns wort etc.. Traditional Chinese medicines prescribed for the treatment of severe viral hepatitis B in the localities were shown to have the same basis as ours, modified by adding scutellaria root, phellodendron bark, giant knotweed rhizome, oldenlandia, subprostrate sophorca root, Chinese angelica root, pilose asiabell root etc., totalling more than 15 traditional Chinese medicines. For patients in the convalescent stage of severe hepatitis with serum total bilirubin and aminotransferases completely restored to normal levels, 3 g of honeyed pills containing freshwater turtle shell, pangolin scales, zedoary, notoginseng, dragon's blood, Chinese angelica root, pilose asiabell root, chicken's gizzardmembane, subprostrate sophora root etc., were given to each of them PO, b.i.d. for 2 consecutive weeks followed by a break of one week. The course of treatment lasted 2 months. Levels of serum total bilirubin, plasma thromboplastin antecedent, hyaluronic acid, laminin, type Ⅲ collagen and type Ⅳcollagen were monitored and compared with those assayed before the treatment. Results:Apparently better therapeutic effectiveness was demonstrated in patients treated with traditional Chinese medicines than in those who were not (P＜0.05). Conclusion:Traditional Chinese medicines were shown to lower the levels of serum total bilirubin in patients with severe chronic viral hepatitis B. Striking amelioration of serum indices of liver fibrosis was also noted in patients in the restoration stage of severe hepatitis associated with hepatic failure as a result of the treatment with traditional Chinese medicines. However, components of traditional Chinese medicines may aggravate injuries of liver cells in the treatment of acute liver failure.
