| Objective To explore the clinical efficacy of Chinese medicine enema-drip combined with lactulose in the treatment ofhepatic encephalopathy (HE) with heat disturbance and its effect on serum endotoxin, blood ammonia and intestinal mucosal barrierfunction.Methods A total of 126 HE patients treated in The Third Hospital of Qinhuangdao from April 2021 to March 2022 were randomly assigned into three groups: lactulose group, traditional Chinese medicine enema-drip group, and lactulose combined with traditional Chinese medicine enema-drip group (combination group), with 42 cases in each group. After receiving routine supportive treatment, the lactulose group received lactulose treatment alone, the traditional Chinese medicine enema-drip group received traditional Chinese medicine enema-drip treatment alone (Rhubarb, Coptis chinensis, Scutellaria baicalensis 20 g each, added with 800 mL of water and frying to 150 mL), and the combination group received a combination of lactulose and traditional Chinese medicine enema-driptreatment. All groups were treated for 1 week. The study observed the changes in the levels of serum endotoxin, blood ammonia, liverfunction indicators [aspartate transaminase (AST), alanine aminotransferase (ALT), total bilirubin (TBil)], inflammatory factors [Tumornecrosis factor-α (TNF-α), interleukin-6 (IL-6)], intestinal mucosal barrier function [diamine oxidase (DAO), D-lactic acid (D-LA)], andtraditional Chinese medicine symptom scores before and after treatment in the three groups. The study also evaluated the improvementtime of mental status, clinical efficacy, and adverse reactions in the three groups.Results There was a significant difference in the im·provement time of mental status among the three groups (P<0.001), in which the combined group (5.84±0.87) d 92.86% in the herbal enema-drip group > 73.81%in the lactulose group. After treatment, there were significant differences in the levels of serum LPS, blood ammonia, TNF-α, IL-6, DAO, D-LA, AST, ALT, TBil, and TCM symptom scores including facial redness, delirium, palpitations, insomnia and dreaminess, drymouth and throat, and irritability among the three groups (all P<0.001). Conclusion The treatment of hepatic encephalopathy with heat disturbance with lactulose and traditional Chinese medicine enema-drip (Sanhuang decoction) is effective in regulating intestinalendotoxins, lowering blood ammonia levels, repairing the intestinal mucosal barrier, shortening the time of mental recovery, improvingliver function, and reducing TCM symptom scores with high safety. |
