OBJECTIVETo evaluate the clinical effect of removing dampness and purgative (RDP) method in treating acute, subacute and chronic severe hepatitis.

METHODSOne hundred and twenty cases of severe hepatitis were randomly assigned to 2 groups, 60 patients in the control group were treated with routine Western medicine, 60 patients in the treatment group were treated with the same Western medicine plus Chinese medicine prescribed based on RDP principle orally and/or via enema. Fourteen days of treatment constituted one therapeutic course, and patients were treated for 3 courses. Changes of clinical symptoms and signs, complication occurrence, liver function, serum markers of hepatitis B virus, and some biological indexes were observed and compared. The case fatality rate was compared after a 6-month follow-up.

RESULTSThe total effective rate and marked improving rate in the treatment group was 71.7% (43/60 cases) and 48.3% (29/60 cases) respectively, while those in the control group, 51.7% (31/60 cases) and 20.0% (12/60 cases) respectively, showing significant difference between the two groups (P < 0.05). After treatment, the clinical symptoms and signs were relieved and complications were reduced in the treatment group, showing marked improvement as compared with that in the control group (P < 0.05). ALT, AST, TBil, quantitative titer of HBV-DNA and HBeAg decreased markedly, and ALB, prothrom-base activity (PTA) and total cholesterol (TC) increased significantly in both groups after treatment (P < 0.01). Significant difference was found in AST, TBil, PTA and quantitative titer of HBV-DNA between the two groups (P < 0.05, P < 0.01). In the 6-month follow-up, the case fatality rate was 23.3% (14/60 cases) in the treatment group, significantly lower than that in the control group (P < 0.05), which was 41.6% (25/60 case)

CONCLUSIONRDP treatment is helpful to improve the prognosis of patients with severe hepatitis, it is one of the effective measures for enhancing the efficacy of comprehensive treatment.