Clinical Study Of Guri Gumu-13 Pill In Treating Liver Damage Caused By Brucellosis

Objective:Guided by the basic theories of Mongolian medicine,By treating liver damage caused by brucellosis with the Mongolian medicine "Guri Gumu 13 Pill",To evaluate the improvement of liver function(ALT、AST、γ-GGT、ALP、TBIL and DBIL)and the clinical efficacy(right upper abdominal pain、nausea、abdominal distension、loss of appetite、indigestion and hypodynamia)of the Mongolian medicine "Guri Gumu 13 Pill" on liver damage,Provide new clinical research ideas and methods for clinical treatment of this disease.Methods:Select the period from December 2021 to February 2023.67 patients aged between 18 and 65 who met the inclusion criteria for liver damage caused by brucellosis were selected and Visiting the Inpatient Department of Brucellosis Department in the Inner Mongolia International Mongolian Medical Hospital.The patients were randomly divided into two groups,33 cases in the treatment group and 34 cases in the control group.In the treatment group,the Mongolian medicine "Guri Gumu 13 Pill" was selected and taken orally at noon,once a day,3g/time.The control group selected western medicine compound glycyrrhizin tablets,2 tablets/time,3 times/day,orally.Observe and record the main clinical symptoms,liver function indicators(ALT、AST、γ-GGT、ALP、TBIL and DBIL),CRP and ESR indicators before treatment and after 7 and 14 days of treatment,Finally,statistical analysis was conducted using SPSS25.0 statistical software.Results:1.General situation:The two groups of patients were compared in terms of gender,age,all clinical manifestations and test indicators before treatment,and there was no significant difference in distribution(P>0.05),indicating comparability.In both groups,there were 49 male patients,accounting for 73.13% of the total number,and 18 female patients,accounting for 26.87% of the total number;The ratio of male to female is 2.7:1.2.Clinical manifestation:2.1 Main clinical manifestations of brucellosis:The main clinical manifestations of brucellosis include: Hyperhidrosis(86.57%),hypodynamia(82.09%),fever(73.13%),bone and joint pain(64.18%),back pain(53.73%),shiver(44.78%),muscle pain(20.90%),splenomegaly(14.93%),hepatomegaly(4.48%),etc.2.2 Main clinical manifestations of liver damage:The main clinical manifestations of liver damage include:Loss of appetite(88.06%)、hypodynamia(82.09%)、abdominal distension(65.67%)、nausea(59.70%)、indigestion(49.25%)、right upper abdominal pain(32.84%),etc.3.laboratory examination:3.1 Various indicators of liver function:3.1.1 Comparison of various indicators of liver function:Inter group comparison: Before treatment,7 days after treatment and 14 days after treatment,compare indicators such as ALT,AST,γ-GGT,ALP,TBIL and DBIL,There was no significant difference in distribution(P>0.05),with no statistical significance.Intragroup comparison: Both groups of patients were before treatment and after 7 days of treatment、before treatment and after 14 days of treatment,compare indicators such as ALT,AST,γ-GGT,ALP,TBIL and DBIL,the difference was statistically significant(P<0.05).3.1.2 Distribution of ALT and AST elevation:Before treatment,elevated slightly in ALT accounted for 43.3%,elevated slightly in AST accounted for 28.4%;Moderate elevation of ALT accounted for 31.3%,Moderate elevation of AST accounted for 23.9%;significantly elevated of ALT accounted for 7.5%,significantly elevated of AST accounted for 3.0% in the two groups of patients.3.2 Comparison of CRP and ESR values:Inter group comparison:There was no significant difference in the distribution of CRP indicators between the two groups before and after treatment,P>0.05.There were significant differences in ESR indicators between the two groups of patients before and after treatment,with P<0.05.Intragroup comparison: The CRP and ESR indexes of the two groups of patients were compared before and after treatment,the difference was statistically significant(P < 0.05).Before the treatment in the two groups of patients,There were 55 patients with elevated CRP,82.09% of the total population;There were 54 patients with elevated ESR,80.60% of the total population.4.Comparison of clinical symptom scores of liver damage:4.1 Comparison of total scores of clinical symptoms of liver damage:Inter group comparison: The two groups of patients were treated for 7 days and 14 days respectively comparison of total clinical symptom scores of liver damage between groups,Results: P<0.05,the difference was statistically significant.Intragroup comparison:Two groups of patients,were before treatment and after 7 days of treatment、before treatment and after 14 days of treatment,Comparative results of total scores for clinical symptoms of liver damage between the two groups.The results are all P<0.05,with significant differences in distribution.4.2 Comparison of clinical symptom scores of liver damage:Inter group comparison: After 14 days of treatment in the two groups,Compare the scores of symptoms such as right upper abdominal pain,nausea,abdominal distension,and indigestion,there was no significant difference between the groups(P>0.05).However,the loss of appetite and hypodynamia symptoms were compared,the difference between the two groups was statistically significant(P<0.05).Intragroup comparison: after comparing the scores of clinical symptoms such as right upper abdominal pain、nausea、abdominal distension、loss of appetite、indigestion and hypodynamia before treatment and after 14 days of treatment in the two groups of patients,the difference was statistically significant(P<0.05).5.Comparison of total effective rate:5.1 Comparison of total effective rates of liver function indicators:Treatment group:The total effective rate of liver function indicators after 7 and 14 days of treatment were 45.5% and 78.8%.Control group:The total effective rate of liver function indicators after 7 and 14 days of treatment were 52.9% and 76.5%.5.2 Comparison of total effective rates of clinical symptoms of liver damage:Comparison of the total effective rate of liver damage symptoms after 7 and 14 days of treatment:The treatment group was 90.9% and 100% respectively;The control group was76.5% and 97% respectively.After 7 and 14 days of treatment,there was no significant difference in the distribution between the two groups(P>0.05).Conclusion:1.Liver function indicators:Mongolian medicine "Guri Gumu 13 Pill" can inhibit the increased serum ALT,AST,γ-GGT,ALP,TBIL and DBIL content;That is to say,it has certain effects on protecting liver parenchymal cells from damage,removing cholestasis in the intrahepatic bile duct,and promoting the excretion function of the intrahepatic biliary tract.2.Clinical manifestations of liver damage:The Mongolian medicine "Guri Gumu 13 Pill" can effectively alleviate symptoms such as right upper abdominal pain、nausea、abdominal distension、loss of appetite、indigestion and hypodynamia due to liver damage caused by brucellosis.However,it has a more significant effect on relieving symptoms of decreased appetite and fatigue.In other words,it has obvious effects on protecting the liver,enhancing appetite and facilitating digestion.3.CRP and ESR indicators:Mongolian medicine "Guri Gumu 13 Pill" can inhibit the elevated serum CRP and ESR levels.In other words,it has an obvious eradicate "nian" effect.