| Background:Cholestatic hepatitis is a kind of hepatopathy caused by abnormal bile formation,secretion and excretion.The main clinical manifestations are fatigue jaundice, pruritus and lighter color stool.Laboratory studies can show the serum bilirubin (mainly includes direct bilirubin),alkaline phosphatase and γ-glutamyl transferase rise.Currently, medical combined modality therapy,such as hepatoprotection.lowering enzymatic and normalizing gallbladder to cure jaundice,is still the main treatment of cholestatic hepatitis. However,even after receiving the above-mentioned treatment,length of patient stay for patients with cholestatic hepatitis is significantly longer than the general patients with hepatitis.Since the Jaundice, usually last long and hard to degrade,so patients who suffer from cholestatic hepatitis need to stay in hospital for longer period,which brings high economic burden and psychological pressure to patients.What is even worse,long-term cholestasis may lead to liver fibrosis and liver failure.Traditional Chinese medicine(TCM)does not record the disease name of cholestatic hepatitis.According to its clinical manifestations,such as xanthochromia of body and eyes, yellow or red urine,cholestatic hepatitis is attributable to "Jaundice" category in TCM.In clinical practice,in line with the basic pathogenesis of "Gallbladder damp heat,blood stasis""heat and dampness,cooling blood" is established as the basic principles for treating cholestatic hepatitis.Objective:This paper conducts a prospective randomized controlled study to observe the clinical efficacy on Western medicine plus Compound Yin Dan decoction for the treatment of acute cholestatic hepatitis.Methods:1.Using prospective randomized controlled study.From December2010to December2012,the cases coming from the patients who were in Beijing Ditan Hospital were enrolled. According to the clinical research program,60cases of acute cholestatic hepatitis patients met the diagnostic criteria included in the observation,were randomly divided into treatment group and control group,30cases in each.2.Patients in both groups using western medicine synthesis treatment,were given routine liver protecting drug:①compound glycyrrhizin,200mg each time,intravenous drip.②the reduced glutathione1.2g/d,intravenous drip.③bile capsule,2capsules, three times a day oral.Patients in the treatment group were administered with compound Yin Dan decoction,150ml each time,once a day.Two groups were treated for4weeks.3.The TCM symptoms before and after treatment and changes in the level of liver function were observed.4.SPSS17.0was used for statistical analysis.Enumeration data adopts chi-square test and measurement data uses t test.Results: 1.Relieving symptoms:After receiving the treatment of one week,the total symptom score(13.19±3.92) of the treatment group was significantly lower than the control group (16.75±5.48)(P<0.05).2.Biochemical indicator:①fter4weeks’treatment, ALT. AST. TBIL, DBIL, ALP. GGT,are significantly decreased than before treatment in both groups(P<0.01).After4weeks’ treatment,ALB and CHE are significantly increased than before treatment in both groups (P<0.01).②The treatment group was better than the control group in improving liver function, TBIL, DBIL、ALP、GGT、TBA,in the treatment group significantly(P<0.05) decreased more during the first week and the second week,compared with the control group.③The normal average time of the serum bilirubin decreasing to less than five times in the treatment group (13.93±6.76) was significantly shorter than the control group(17.90±8.12),P<0.05.Conclusion:Compound YinDan decoction in treating acute cholestatic hepatitis can significantly improve the clinical symptoms,speed up the jaundice subsiding.decrease TBIL, DBIL, ALP. GGT, TBA,improve Cholestasis,and promote the recovery of the disease. |
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