The Clinical Research Of Soothing And Yangxue Treatment To The Cirrhosis By Hepatitis B With Hyperammonemia(Liver Depression And Blood Deficiency Type)

ObjectiveTCM syndrome differentiation treatment to cirrhosis byhepatitis b with hyperammonemia. Observe the curative effect, andtry to illustrate the mechanism of traditional Chinese medicinetreatment to hyperammonemia. Hope to find a safe, non-toxic andeffective treatments from traditional Chinese medicine. Improvethe patient’s clinical symptoms, improve the quality of life.MethodFrom wuhan city hospital of traditional Chinese medicine clinicpatients, select63people. Accord with the diagnostic criteria forcirrhosis by hepatitis b, and accord with the diagnostic criteriafor hyperammonemia. And TCM clinical syndrome differentiation ofLiver depression and Blood deficiency type. Randomly divided intotwo groups, control group31people, the treatment group32people.The basic treatment of two groups is the same, all patients istreated with nucleoside antiviral drugs; People who have esophagealand gastric varices bleeding or have the possibility of rebleeding,treatment with propranolol, reduce the pressure of portal vein in order to reduce the possibility of bleeding; Liver function isabnormal and transaminase lifts (especially the ALT elevations),treatment with wuzhi jiaonang; There is a lot of ascites or pleuraleffusion, use spironolactone and Cefuroxime Sammy combined therapyin order to enhance diuresis action,or intravenous drip bloodalbumin increased plasma osmotic pressure. The basis treatment isthe same, the control group, oral Ornithine Aspartate Grenules;Treatment group, make Soothing and Yangxue as the basic method,andmake Xiaoyao San as basic Fang, syndrome differentiation treatment.The design of experiment observation time for eight weeks. Nospecial circumstances, patients see a doctor once a week,andobserve the changes of illness. Treatment group treated withtraditional Chinese medicine, along with the disease changes to addand subtract for treatment. Detection of two groups of patientsbefore and after the treatment of liver function、AMM，do liverspleen and pancreatic imaging studies, and observation of clinicalsymptoms. Statistical processing, sums up the treatment curativeeffect. During the experiment,observation patient’s c changes ofillness, in order to timely find the adverse reactions,and makea timely treatment.ResultIn the aspect of TCM clinical symptoms improved，according tothe clinical symptom score，treatment group32cases, clinical cured7cases (21.88%),13cases were markedly improved (40.63%),effective9cases (28.13%), invalid3cases (9.38%), the totaleffective rate was90.63%; And control group, the clinical cure in2cases (6.45%),7cases were markedly improved (22.58%), effective 12cases (38.71%), invalid10cases (32.26%), the total effectiverate was67.74%. Statistical analysis, traditional Chinesemedicine treatment of hyperammonemia, in the aspect of the clinicalsymptoms improved, is better than oral Ornithine AspartateGrenules group. In the aspect of clinical comprehensive curativeeffect of improved, eight weeks after treatment in both groups.Treatment group32cases,17cases were markedly improved (53.13%),effective11cases (34.38%),4had no effect (12.50%), the totaleffective rate was87.50%; Control group31cases,7were markedlyimproved cases (22.58%), effective13cases (41.94%),11cases hadno effect (35.48%), the total effective rate was64.52%. By thestatistical analysis，shows that treatment of traditional Chinesemedicine group the total efficacy were better than oral OrnithineAspartate Grenules group. In addition, in improving the AMM、ALTon indicators, two groups of curative effect is significant. Buton the improvement of AMM index, traditional Chinese medicine (TCM)syndrome group were better than oral Ornithine Aspartate Grenulesgroup. On the improve the ALT indexes, Oral Ornithine AspartateGrenules group and Soothing and Yangxue group have the similareffect.ConclusionThrough the experimental study shows that, traditional Chinesemedicine treatment of hyperammonemia, in improving clinicalsymptoms, curative effect significantly better than oral OrnithineAspartate Grenules group; Syndrome differentiation of traditionalChinese medicine treatment group decreased blood ammonia, curativeeffect is slightly better than the control group; On the improve the ALT indexes, Oral Ornithine Aspartate Grenules group andSoothing and Yangxue group have the similar effect. And during thetest, patients with no obvious adverse reactions. Make clear thatTCM treatment of cirrhosis by hepatitis b with hyperammonemia issafe and effective.