Effecacy And Safety Of Integrative Medical Program Based On "Yang Huang-Yinyang Huang-Yin Huang" In Treating Patients With Hepatitis B Virus Related Acute-on-chronic Liver Failure

Objective:To evaluate the short-term clinlical efficacy of "Yang huang-Yinyang huang-Yin huang" syndrome differentiation and treatment mode for120patients with hepatitis B related acute on chronic liver failure; to summarize the clinical characteristics of the Chinese medicine effective intervention group cases.Method:Adopting multicenter randomized controlled trial,120patients of hepatitis B related acute-on-chronic liver failure were randomly divided into trial group and control group, each group of60cases. The trial group was given western medicine comprehensive treatment, and on the basis of western medicine comprehensive treatment, the control group was given "Yang huang-Yinyang huang-Yin huang" syndrome differentiation and treatment for8weeks. In front of the group into the baseline characteristics between the comparison group,8weeks after the treatment,compare the primary effect and secondary effect index of the two groups, and conclude the main efficacy of traditional Chinese medicine interventions.Result:When two groups patients into the group of routine blood, liver function, renal function, electrolyte, blood coagulation function, AFP, hepatitis b E antigen (HBeAg) positive rate, the hepatitis b virus (HBVDNA) quantitative results no significant difference (P>0.05), two groups of patients with clinical stage of liver failure form than the same, two groups of patients in TCM clinical symptom scores, no significant differences on quality of life score, no statistical significance (P>0.05); Primary effect:Deaths from8weeks after treatment in the two groups respectively,10cases and12cases, case fatality rate were16.7%and20.0%respectively, the total fatality rate of no significant difference in both groups(P>0.05); Two groups of patients with early, middle and late mortality were14.3%,22.0%vs25.0vs9.1%%%,50.0%vs66.7, by fisher’s exact test probability method, no difference between the two groups of case fatality rate for all stages.(P>0.05);Secondary effect:①Liver function The experimental group after treatment began to total bilirubin decreased than control group obviously, the clear difference between groups (P<0.05), alanine aminotransferase decreased significantly after treatment began to two groups, but the experimental group than the control group was no significant difference (P>0.05), serum albumin were recovered after treatment began to clear, but the experimental group than the control group was no significant difference (P>0.05);②Clinical symptoms integral:After treatment began to two groups of traditional Chinese medicine clinical symptoms integral are in rapid decline, but was no significant difference between groups (P>0.05);③The incidence of complications:Experimental group and control group of ascites, hepatic encephalopathy, gastrointestinal bleeding, idiopathic peritonitis, infection rate has no obvious difference (P>0.05) and control group in incidence of hepatorenal syndrome is higher than the experimental group (P<0.05), the difference was statistically significant;④coagulation function:Two groups of prothrombin time relatively overall tend to fall into the group, compared with the group P=0<0.05, with statistical significance, the experimental group compared with the control group of prothrombin time no significant difference, P=0.227>0.05, no statistical significance⑤Jaundice curative effect:Presented the total effective rate was85.0%, while the control group was63.3%, high efficient than controls, P=0.042<0.05, with statistical significance.4.No obvious adverse evernt occurred in the two groups during the8-week treatment period. Conclusion:1.The "Yang huang-Yinyang huang-Yin huang" syndrome differentiation and treatment mode combined with western medicine comprehensive treatment does not affect short-term mortality in patients with hepatitis B related acute on chronic liver failure2. The "Yang huang-Yinyang huang-Yin huang" syndrome differentiation and treatment mode combined with western medicine comprehensive treatment to reduce patients ascites, hepatic encephalopathy, gastrointestinal bleeding, spontaneous peritonitis, infection rate has no obvious effect, but it can reduce the incidence of hepatic failure patients with hepatorenal syndrome.3.The "Yang huang-Yinyang huang-Yin huang" syndrome differentiation and treatment mode combined with western medicine comprehensive treatment has no obvious promoting role to alleviate symptoms of liver failure patients consciousness.4.The "Yang huang-Yinyang huang-Yin huang" syndrome differentiation and treatment mode combined with western medicine comprehensive treatment can obviously promote the patients total bilirubin fade, and shorten the hospitalization period.