中医辨证治疗肝硬变腹水56例  

Fifty-Six Cases of Hepatic Cirrhosis Ascites Treated Based on TCM Syndrome Differentiation

作　　者：李广宣 LI Guang-xuan(Suixian Hospital of Traditional Chinese Medicine,Suixian,Heuan,China,47690)

机构地区：[1]睢县中医院,河南睢县476900

出　　处：《河南中医》2018年第8期1194-1197,共4页Henan Traditional Chinese Medicine

基　　金：河南省中医药科学研究专项课题项目(编号:2015ZY02033)

摘　　要：目的:观察中医辨证治疗肝硬变腹水的临床效果。方法:选取2016年1月至2017年3月本院收治的Child-Pugh分级为B^C级的乙型肝炎、丙型肝炎及胆汁瘀积性肝病的肝硬变腹水患者112例,按照随机数字表法分为治疗组和对照组,每组56例。对照组给予西医综合治疗,保证充足的休息时间,给予饮食护理干预,严格控制水、钠的摄入,积极治疗原发病,同时给予保肝降酶及利尿剂治疗,治疗组在对照组治疗的基础上给予自拟中药汤剂治疗。结果:治疗组有效率为91.07%,对照组有效率为75.00%,治疗组有效率优于对照组(P<0.05),差异有统计学意义;治疗组治疗后总胆红素(total bilirubin,TBIL)、丙氨酸氨基转移酶(alanine transaminase,ALT)、天冬氨酸氨基转移酶(aspartateaminotransferase,AST)、血清白蛋白(albumin,ALB)水平优于对照组,差异有统计学意义;治疗组治疗后腹水深度、脾脏厚度、门静脉内径优于对照组,差异有统计学意义(P<0.05)。结论:中医辨证治疗肝硬变腹水疗效显著,可有效缓解患者临床症状,改善肝功能。Objective： To observe the clinical curative effect of treatment based on TCM syndrome differentiation on hepatic cirrhosis ascites. Methods： One hundred and twelve cases of liver cirrhosis with hepatitis B,hepatiti C and cholestasis with Child-Pugh classified as B ~ C treated in our hospital from January 2016 to March 2017 were selected and divided them into the treatment group and the control group according to the random number table method,with 56 cases in each group. The ones in the control group were given comprehensive treatment of Western medicine,ensuring adequate rest time,dietary nursing intervention,strictly control the intake of water and sodium,actively treating the original disease At the same time,they were given the liver preservation and reducing enzyme and diuretic treatment,and the ones in the treatment group were given the self-made decoction of traditional Chinese medicine on the basis of the control group. Results： The effective rate was 91. 07% in the treatment group and75% in the control group. The effective rate of the treatment group was better than that of the control group（ P〈 0. 05）. The difference was statistically significant. The total bilirubin（ TBIL）,alanine aminotransferase（ ALT） and aspartate aminotransferase（ AST） after the treatment in the treatment group were statistically significant,and serum albumin（ ALB） were superior to those of the control group,and the differences were statistically significant. The depth of ascites,the thickness of the spleen and the internal diameter of the portal vein in the treatment group were better than those in the control group,the differences were statistically significant（ P〈 0. 05）. Conclusion： TCM syndrome differentiation has a remarkable clinical curative effect on hepatic cirrhosis ascites,can effectively relieve clinical symptoms and improve liver function.

关 键 词：肝硬变 腹水 辨证治疗 脾肾阳虚证 肝肾阴虚证 湿热蕴结证 气滞湿阻证 

分 类 号：R259.752[医药卫生—中西医结合]