Clinical Study On Modified Guiyi Decoction In The Treatment Of Acute-on-Chronic Liver Failure (Spleen And Kidney Yang Deficiency Syndrome)

Object:The purpose of this study is to evaluate the overall efficacy of integrated traditional Chinese and Western medicine in the treatment of patients with acute-on-chronic liver failure(spleen and kidney yang deficiency syndrome)on the basis of Western medicine treatment,The overall evaluation of the overall efficacy of integrated traditional Chinese and Western medicine in the treatment of this disease provides strong evidence for further blocking the development of the disease,improving clinical survival rate and reducing mortality.Methods:In this study,60 patients with acute-on-chronic liver failure(ACLF)who met the inclusion criteria were randomly divided into treatment group(30 cases)and control group(30 cases).The control group was treated with comprehensive treatment of Western medicine,and the treatment group was treated with modified Guiyi Yin on the basis of the control group for 8 weeks.Total bilirubin(TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST),albumin(ALB),international normalized ratio(INR),prothrombin time activity(PTA),TCM symptom score,survival rate and clinical efficacy were observed before treatment,4 weeks and 8 weeks after treatment.All the results were compared to evaluate the therapeutic effect of Guiyi Decoction.Results:1.After 4 weeks of treatment,27 patients survived in the treatment group and 25 patients survived in the control group.The survival rate was90%in the treatment group and 83.3%in the control group.There was no significant difference between the two groups(X~2=0.144,P=0.704);After 8weeks of treatment,25 patients survived in the treatment group and 18patients survived in the control group.The survival rate of the treatment group was 83.3%,and the survival rate of the control group was 60%.The survival rate of the treatment group was higher than that of the control group(X~2=4.022,P=0.045);The total effective rate of the treatment group was73.3%,and the total effective rate of the control group was 46.7%.The curative effect of the treatment group was significantly better than that of the control group(X~2=4.444,P=0.035).2.Liver function:Before treatment,there was no significant difference in TBIL,ALT,AST and ALB between the two groups(t=-0.147,0.715,0.318,0.443,P>0.05).After 4 weeks of treatment,the liver function(TBIL,ALT,AST,ALB)indexes of the two groups decreased significantly.At the 4th week,the improvement of liver function(TBIL,ALT,AST,ALB)in the treatment group was more significant than that in the control group(t=-2.194,-2.340,-2.210,2.204,P<0.05).After 8 weeks of treatment,the improvement of liver function(TBIL,ALT,AST,ALB)in the treatment group was still better than that in the control group(t=-2.027,-2.041,-2.615,3.206,P<0.05).3.Coagulation function:There was no significant difference in coagulation function(INR,PTA)between the two groups before treatment(t=-0.238,0.213,P>0.05).After treatment,the coagulation function(INR,PTA)of the two groups were significantly improved.After 4 weeks of treatment,the efficacy of the treatment group was better(t=-2.067,2.349,P<0.05).After 8 weeks of treatment,there was no significant difference in INR efficacy between the two groups(t=-1.765,P>0.05).However,the increase of PTA in the treatment group was more significant than that in the control group(t=2.231,P<0.05).4.TCM symptom efficacy score:There was no significant difference in TCM symptom efficacy scores between the two groups before treatment,and there was no statistical significance(t=-1.667,P>0.05).After 4 weeks and 8weeks of treatment,the TCM symptom efficacy scores were significantly reduced,and the treatment group showed significant advantages compared with the control group at the same time(t=-2.307,-2.177,P<0.05).Conclusion:This clinical research experiment shows that Guiyiyin Jiawei combined with western medicine comprehensive treatment can effectively alleviate the clinical symptoms of ACLF patients with spleen and kidney yang deficiency,improve the survival rate,reduce the mortality rate,improve the liver function,reduce the coagulation dysfunction,and its clinical adverse reactions are less,the safety is higher,the combined application effect is better than the simple western medicine treatment,which is worthy of clinical promotion and application.