自拟温阳利水汤对脾肾阳虚型肝硬化腹水的疗效及对肝功能的影响  

Self-made Wenyang Lishui Decoction for the treatment of ascites due to spleen and kidney yang deficiency cirrhosis and its influence on liver function index

作　　者：刘俊玲 张娟 张运豪 李锐[3] LIU Jun-ling;ZHANG Juan;ZHANG Yun-hao(Department of Liver Disease,Handan Hospital of Infectious Disease,Handan Hebei,056000,China;不详)

机构地区：[1]邯郸市传染病医院肝科,河北邯郸056002 [2]邯郸市传染病医院中医内科 [3]邯郸市中医院药剂科

出　　处：《中西医结合肝病杂志》2021年第6期506-508,共3页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：河北省中医药管理局科研计划项目(No.2020597)。

摘　　要：目的:探讨自拟温阳利水汤治疗脾肾阳虚型肝硬化腹水的疗效及其对肝功能的影响。方法:2017年6月至2019年1月收治脾肾阳虚型肝硬化腹水患者108例,随机分为观察组(n=54)和对照组(n=54)。对照组患者采用西医常规治疗,观察组患者在对照组基础上加用自拟温阳利水汤进行治疗,2周为1个疗程,治疗2个疗程。观察两组患者的疗效及治疗前后腹围、体重、治疗期间24 h尿量、超声腹水最大深度、肝功能指标、中医症候积分。结果:治疗后,与对照组比较,观察组患者腹围、体重和超声腹水最大深度均较低,而24 h尿量较多(P<0.05);谷丙转氨酶、谷草转氨酶和总胆红素明显较低,而白蛋白较高(P<0.05)。与对照组比较,观察组患者腹胀、少尿、肢体水肿、乏力、纳差积分及总中医症候积分较低(P<0.05)。观察组无效7例、有效Ⅰ级15例、有效Ⅱ级24例、有效Ⅲ级8例,对照组分别为15、18、15和6例,组间比较差异有统计学意义(P<0.05)。结论:自拟温阳利水汤联合西医常规治疗脾肾阳虚型肝硬化腹水的效果较好,可明显改善患者的腹水症状和肝功能。Objective:To explore the effect of self-made Wenyang Lishui Decoction on ascites due to spleen and kidney yang deficiency cirrhosis and its influence on liver function indexes.Methods:From June 2017 to January 2019,108 patients with ascites due to cirrhosis of the spleen,kidney and Yang deficiency in our hospital were randomly divided into observation group(n=54)and control group(n=54).The control group was treated with conventional Western medicine,and the observation group was treated with self-made Wenyang Lishui Decoction based on the control group.2 weeks was a course of treatment,and the patients were evaluated after 2 courses of treatment.Before and after treatment,the abdominal circumference,body weight,24h urine volume during treatment,the maximum depth of ultrasound ascites,liver function index and TCM symptom score were observed.Compared the treatment effect of the two groups.Results:After treatment,compared with the control group,the observation group's abdominal circumference,body weight,and ultrasound maximum depth of ascites were lower,while the 24-hour urine output was higher(P<0.05).Compared with the control group,the observation group alanine aminotransferase,aspartate aminotransferase and total bilirubin were significantly lower,while albumin was higher(P<0.05).Compared with the control group,the observation group had lower abdominal distension,oliguria,limb edema,fatigue,anorexia and total TCM symptom scores(P<0.05).In the observation group,7 cases were ineffective,15 cases were effective in gradeⅠ,24 cases were effective in gradeⅡ,and 8 cases were effective in gradeⅢ.The control group was 15 cases,18 cases,15 cases and 6 cases,and there was a statistical difference between the groups(P<0.05).Conclusion:The self-made Wenyang Lishui Decoction combined with Western medicine routine treatment of spleen and kidney yang deficiency liver cirrhosis ascites has better effect,which can significantly improve the symptoms of ascites and liver function.

关 键 词：肝硬化 腹水 自拟温阳利水汤 

分 类 号：R575.2[医药卫生—消化系统]