改良温阳利水汤佐治脾肾阳虚型肝硬化腹腔积液疗效观察  

Efficacy of Modified Wenyang Lishui Decoction in the Adjuvant Treatment of Ascites Induced by Liver Cirrhosis with Spleen and Kidney Yang Deficiency Type

作　　者：刘俊玲 张娟 张运豪 王兵亮[1] 李锐[2] LIU Junling;ZHANG Juan;ZHANG Yunhao;WANG Bingliang;LI Rui(Handan Infectious Disease Hospital,Handan,Hebei,China 056002;Handan Hospital of Traditional Chinese Medicine,Handan,Hebei,China 056000)

机构地区：[1]河北省邯郸市传染病医院,河北邯郸056002 [2]河北省邯郸市中医院,河北邯郸056000

出　　处：《中国药业》2021年第10期75-77,共3页China Pharmaceuticals

基　　金：河北省中医药管理局科研计划项目[2020597]。

摘　　要：目的探讨改良温阳利水汤佐治脾肾阳虚型肝硬化腹腔积液的疗效,以及对患者生化指标、肝纤维化指标的影响。方法选取河北省邯郸市传染病医院2018年3月至2020年3月收治的脾肾阳虚型肝硬化腹腔积液患者60例,按随机数字表法分为对照组和观察组,各30例。对照组患者给予常规西医治疗,观察组患者在此基础上联合改良温阳利水汤治疗。两组均连续治疗4周。结果观察组总有效率为93.33%,显著高于对照组的73.33%(P<0.05);与对照组比较,治疗后观察组患者的体质量、腹围、脾脏厚度均显著降低,肝功能生化指标(总胆红素、丙氨酸氨基转移酶、天冬氨酸氨基转移酶)水平均显著降低,患者的肝纤维化指标(Ⅲ型前胶原肽、层粘连蛋白、透明质酸)水平均显著降低(P<0.05);观察组和对照组不良反应发生率相当(16.67%比10.00%,P>0.05)。结论改良温阳利水汤佐治脾肾阳虚型肝硬化腹腔积液疗效较好,能改善患者的症状体征、肝功能指标、肝纤维化指标,且安全性较好。Objective To investigate the efficacy of modified Wenyang Lishui Decoction in the adjuvant treatment of patients with ascites due to liver cirrhosis with spleen and kidney yang deficiency type and its effect on the biochemical indexes and liver fibrosis indexes.Methods A total of 60 patients with ascites due to liver cirrhosis with spleen and kidney yang deficiency type in the Handan Infectious Disease Hospital from March 2018 to March 2020 were selected and randomly divided into the observation group and the control group,30 cases in each group.The patients in the two groups were treated with conventional Western medicine,on this basis,the patients in the observation group were treated with modified Wenyang Lishui Decoction.Both groups were continuously treated for four weeks.Results The total effective rate of the observation group was 93.33%,which was significantly higher than 73.33%of the control group(P<0.05).The body weight,abdominal circumference and spleen thickness in the observation group were significantly lower than those in the control group(P<0.05).The levels of biochemical indexes of liver function[total bilirubin(TBiL),alanine aminotransferase(ALT)and aspartate aminotransferase(AST)]in the observation group were significantly lower than those in the control group(P<0.05).The levels of liver fibrosis indexes[typeⅢprocollagen peptide(PC-Ⅲ),laminin(LN)and hyaluronic acid(HA)]in the observation group were significantly lower than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was similar to that in the control group(16.67%vs.10.00%,P>0.05).Conclusion Modified Wenyang Lishui Decoction is effective and safe in the adjuvant treatment of ascites due to liver cirrhosis with spleen and kidney yang deficiency type,which can improve the symptoms and signs,liver function indexes and liver fibrosis indexes of the patients.

关 键 词：肝硬化 腹腔积液 脾肾阳虚型 温阳利水汤 临床疗效 肝功能 肝纤维化 

分 类 号：R932[医药卫生—生药学] R285.6[医药卫生—药学]