利水消臌方联合中医外治法治疗乙型肝炎肝硬化顽固性腹水的临床研究  

Clinical observation of Lishui Xiaogu prescription combined with oral acupoint Injection and Chinese medicine external application on intractable ascites due to hepatocirrhosis after hepatitis B

作　　者：王岗[1] 朱琦[1] 唐娟[1] 陈新[1] 车德亚 WANG Gang;ZHU Qi;TANG Juan;CHE De-ya(The First People's Hospital of Zigong City(Sichuan,Zigong,643000),China)

机构地区：[1]四川省自贡市第一人民医院中西医结合科,四川自贡643000

出　　处：《中西医结合肝病杂志》2021年第7期609-612,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：四川省中医药管理局科学技术研究专项基金(No.2018QN073);自贡市市级重点科技计划项目专项基金(No.2018CXMZ04)。

摘　　要：目的:观察利水消臌方联合中医外治法治疗乙型肝炎后肝硬化顽固性腹水的疗效。方法:选取本院2017年1月至2019年7月的乙型肝炎后肝硬化顽固性腹水患者128例,随机分为对照组、中药组、联合组各42例。对照组患者采用常规西医基础治疗;中药组患者在对照组患者治疗基础上加服利水消臌方;联合组患者在中药组治疗基础上加用中药腹部外敷和足三里、蠡沟穴位注射参麦注射液。连续治疗4周,观察3组患者治疗前后体重、腹围、24 h尿量、临床症状积分(腹部胀满、脘闷纳呆、神疲怯寒、下肢水肿)、肝脏超声评分、谷丙转氨酶(ALT)、谷草转氨酶(AST)、白球蛋白比(A/G)、总胆红素(TBil)、内皮素1(ET-1)、NO的水平变化,并进行疗效判定。结果:治疗4周后联合组患者在腹围和24 h尿量变化优于其他两组,差异有统计学意义(P<0.05);治疗后联合组患者体重下降仅优于对照组;治疗后联合组患者在临床症状积分和超声评分均优于其余两组,差异有统计学意义(P<0.05);治疗后联合组患者AST水平改善仅优于对照组(P<0.05),与中药组差异无统计学意义(P>0.05);而TBil、A/G、ALT、ET-1、NO指标改善则优于其余两组,差异均有统计学意义(P<0.05)。联合组患者的临床疗效优于其余两组,差异有统计学意义(P<0.05)。结论:利水消臌方联合中医外治法,可显著提高乙型肝炎后肝硬化顽固性腹水的治疗效果,临床应用方便,患者易于接受,值得临床推广应用。Objective:To observe the curative effect of Lishui xiaogu orally combined with acupoint injection and external application of Chinese medicine on intractable ascites due to liver cirrhosis after hepatitis B.Methods:A total of 128 patients with intractable ascites due to post hepatitis B cirrhosis from January 2017 to July 2019 in Zigong First People's Hospital was selected as the test subjects and randomly divided into a control group,a traditional Chinese medicine group,and a combined group,each with 42 cases.For the basic treatment of Western medicine,the Chinese medicine group took Lishui Xiaogu oral on the basis of the control group,and the combined group received an abdominal application of traditional Chinese medicine and Shenmai injection on Zusanli and Ligou points on the basis of the Chinese medicine group.After continuous treatment for four weeks,the weight,abdominal circumference,24-hour urine output,clinical symptom score(abdominal fullness,dullness,numbness,dizziness and cold,lower extremity edema),liver ultrasound score,and alanine aminotransferase were observed in the three groups before and after treatment(ALT),aspartate aminotransferase(AST),white ball ratio(A/G),total bilirubin(TBil),endothelin 1(ET-1),nitric oxide(NO)changes,and efficacy evaluation.Results:Four weeks later,the combined group had better abdominal changes and 24-hour urine output than the traditional Chinese medicine group and the control group,the difference was statistically significant(P<0.05),and in terms of body weight,the combined group was only better than the control group after treatment,There was no statistically significant difference with the traditional Chinese medicine group(P>0.05).In the clinical symptom score and liver ultrasound score,the combined group's clinical symptom score(abdominal fullness,dullness,dullness,nervousness,lower limb edema)and ultrasound score were better than the other two groups,the difference was statistically significant(P<0.05).In terms of laboratory tests,the combined group is only supe

关 键 词：乙型肝炎后肝硬化 顽固性腹水 利水消臌方 中药外敷 穴位注射 

分 类 号：R575.1[医药卫生—消化系统]