徒都子补气汤加减联合西医常规疗法治疗肝硬化顽固性腹水的临床观察  

Clinical observation on treatment of refractory ascites in liver cirrhosis by modified Tuduzi Buqi Decoction combined with western medicine conventional therapy

作　　者：周扬 邢枫[2] 赵长青[2] 董春玲[2] 袁继丽[2] 刘成海[2] ZHOU Yang;XING Feng;ZHAO Changqing;DONG Chunling;YUAN Jili;LIU Chenghai(The Second Department of Preventive Treatment,Yueyang Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;The Second Department of Liver Diseases,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院治未病二科,上海200437 [2]上海中医药大学附属曙光医院肝病二科,上海201203

出　　处：《上海中医药杂志》2021年第5期67-69,76,共4页Shanghai Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(81573794);2019上海中医药大学杏林传承型人才培养项目。

摘　　要：目的观察徒都子补气汤加减联合西医常规疗法治疗肝硬化顽固性腹水的临床疗效。方法将57例肝硬化顽固性腹水患者分为治疗组(32例)和对照组(25例)。对照组采用西医常规治疗,治疗组在西医常规治疗的基础上加用徒都子补气汤,两组疗程均为14 d。观察比较腹水相关指标(24 h尿量、体质量、腹围、仰卧位腹水深度)及实验室相关指标(肝功能、肾功能、电解质、凝血功能)的变化情况。结果 (1)治疗7 d与治疗前组内比较,治疗组24 h尿量增加(P<0.05),体质量、腹围、仰卧位腹水深度减少(P<0.05),对照组上述指标差异无统计学意义(P>0.05);治疗14 d与治疗前组内比较,两组上述腹水相关指标差异有统计学意义(P<0.05)。治疗7 d、治疗14 d组间比较,24 h尿量、仰卧位腹水深度差异有统计学意义(P<0.05)。(2)治疗14 d与治疗前组内比较,对照组血清肌酐水平升高(P>0.05),治疗组肝功能、肾功能、电解质、凝血功能相关指标差异无统计学意义(P>0.05)。治疗14 d组间比较,上述指标差异均无统计学意义(P>0.05)。结论相较于单纯采用西医常规疗法,加用徒都子补气汤更有助于肝硬化顽固性腹水的消退,且未增加肾功能损伤、电解质紊乱的风险。Objective To observe the clinical effect of modified Tuduzi Buqi Decoction combined with western medicine conventional therapy on the treatment of refractory ascites in liver cirrhosis. Methods Fifty-seven patients with refractory ascites in liver cirrhosis were divided into treatment group(n=32) and control group(n=25). The control group was administered with western medicine conventional therapy, while the treatment group was additionally administered with Tuduzi Buqi Decoction besides the western medicine conventional therapy. The course of treatment in both groups lasted 14 days. We compared the changes of ascites related indicators(24-hour urine volume, body mass, abdominal circumference, and ascites depth in supine position) and laboratory related indicators(liver function, renal function, electrolyte, and coagulation function). Results(1)According to the intra-group comparison before and after 7 days of treatment, in the treatment group the 24-hour urine volume increased(P<0.05), and the body mass, abdominal circumference, and depth of ascites in supine position decreased(P<0.05). However, there was no significant difference in the above indicators in the control group(P>0.05). According to the intra-group comparison before and after 14 days of treatment, there were significant differences in the above-mentioned ascites related indicators in both groups(P<0.05). According to the inter-group comparison after 7 days of treatment and 14 days of treatment,there were significant differences in 24-hour urine volume and ascites depth in supine position between the two groups( P<0.05).(2)According to the intra-group comparison before and after 14 days of treatment,the serum creatinine level in the control group increased( P>0.05),but there was no significant difference in indicators of liver function,renal function,electrolyte,and coagulation function in the treatment group( P > 0. 0 5).According to the inter-group comparison after 14 days of treatment,there was no significant difference in the above indicators be

关 键 词：肝硬化 顽固性腹水 徒都子补气汤 肾功能 电解质 临床研究 

分 类 号：R575.2[医药卫生—消化系统]