The Effect Of The Whole Colonic Perfusion Dialysis With Modified Changpu Yujin Decoction On Overt Hepatic Encephalopathy Of Liver Cirrhosis And NH₃,LPS

Objective:In order to observe the changes of clinical symptoms and blood ammonia,endotoxin levels and liver function(ALT,ALB,TBIL),before and after treatment of patients with overt hepatic encephalopathy of liver cirrhosis.Comparing the results of experimental group and the performance of control group to evaluate the clinical effect of the treatment of overt hepatic encephalopathy of liver cirrhosis with the treatment of the whole colonic perfusion dialysis with modified Changpu Yujin decoction and and the effect of blood ammonia,endotoxin and liver function.In addition,this research also explores the mechanism of its action.Methods:The prospective,random and controlled design were used for this study.All the subjects conformed the diagnostic criteria of overt hepatic encephalopathy of liver cirrhosis.They were hospitalized in the digestive department of the first affiliated hospital of Henan University of traditional Chinese Medicine from January 2017 to January 2018.The patients were randomly divided into treatment group and control group according to 1:1 ratio,30 cases in each group.These two groups were given basic treatment for Western Medicine,including the removal of hepatic encephalopathy,the protection of liver function,nutritional support,and giving the L-ornithine-L-aspartate to reductive blood ammonia.The treatment group was used to treat the whole colonic perfusion dialysis based on basic treatment,and the control group was treated with lactulose enema.Both groups were treated 1 times a day for 1 week.To observe the changes of the two groups before and after treatment of clinical symptoms and blood ammonia,endotoxin and liver function,Then comparing the performance of two groups to evaluate the clinical effect of the treatment of overt hepatic encephalopathy of liver cirrhosis with the treatment of the whole colonic perfusion dialysis with modified Changpu Yujin decoction and the effect of blood ammonia,endotoxin and liver function.Results:1.Influence on mental and neurologic symptoms:The mental and neurologic symptoms of the experimental group and the control group were improved significantly after treatment(P<0.05),and the improvement in the experimental group was more significant(P<0.05).2.The effect on the time required to restore to the 0 level or normol: The time of recovery to the 0 level or normal in the experimental group was significantly shorter than that in the control group(P<0.05).3.Influence on blood ammonia:After treatment,the blood ammonia of both the experimental group and the control group both decreased significantly(P<0.05),and the decrease in the experimental group was more significant(P<0.05).4.Influence on endotoxin :After treatment,the endotoxin of both the experimental group and the control group decreased significantly(P<0.05),and the decrease in the experimental group was more significant(P<0.05).5.Influence on liver function:After treatment,the ALT and TBIL of the experimental group and the control group were obviously improved(P<0.05).The improvement of the level of ALT and TBIL in the experimental group were more obvious(P<0.05).The improvement of ALB in the both groups were not obviously after treatment(P>0.05).6.The effect on every symptom of traditional Chinese Medicine:After treatment,the effects of the experimental group and the control group were significantly improved(P<0.05),and the improvement of the experimental group was more significant(P<0.05).Two groups of patients with the secondary symptoms were significantly improved after treatment(P<0.05),in the jaundice,constipation,high heat polydipsia and stay ou evil more significant effect in experimental group(P<0.05).7.Influence on TCM symptom score:After treatment,the total scores of the two groups were decreased(P<0.05),and the decrease in the experimental group was more obvious(P<0.05).Conclusion:The results of this clinical study shows that,?The clinical curative effect,treating overt hepatic encephalopathy of liver cirrhosis by the whole colonic perfusion dialysis with modified Changpu Yujin decoction,is better than the control group.?Comparing the treatment group with the control group,the former can significantly improve the lower blood ammonia,endotoxin and liver function(ALT,TBIL).