The clinical observation and mechanism of the treatment of minimal hepatic encephalopathy with Da-Huang-Wu-Mei-Decoction with preserved enema
Objective:To explore the clinical efficacy and mechanism of Dahuang Wumei Decoction for the treatment of minimal hepatic encephalopathy by preserving the enema.Methods:Thirty-four patients with confirmed minimal hepatic encephalopathy and splenic insufficiency associated with TCM-defined rheumatic fever were randomly divided into experimental group and control group.Both groups were treated with traditional chinese and western comprehensive basic therapy and experiment group were treated with Dahuang Wumei Decoction to preserve enema.The control group was treated with oral rifaximin for two weeks.Comparison of NCT-A score,DST score,IL-6,IL-1 β,TNF-a,ammonia,and TCM symptom scores before and after treatment;High-throughput pyrosequencing of 16S rDNA in fresh stools collected before and after treatment.Results:The differences in NCT-A score,DST score,IL-6,IL-1 β,TNF-α,ammonia,and TCM symptom scores before and after treatment were statistically significant(P<0.05).Compared with the control group,there were statistically significant differences in TCM symptomatic improvement,lower ammonia levels,NCT-A score,DST score,and lower levels of IL-6 and IL-1β(P<0.05).Shannon index was elevated in the experimental group after treatment(P=0.036).Conclusion:Dahuang Wumei Decoction with preserved enema can regulate the intestinal microflora,Decrease proinflammatory factor secretion,reduce blood ammonia and improve neurocognitive function.