实脾饮合软肝煎治疗脾肾阳虚型肝硬化腹水的临床研究  

Clinical Study on Treatment of Ascites Due to Cirrhosis of Spleen and Kidney Yang Deficiency Type by Combination of Shipi Decoction(实脾饮)and Ruangan Decoction(软肝煎)

作　　者：叶青 蔡乃亮 苏海周 YE Qing;CAI Nailiang;SU Haizhou(Sanya People's Hospital,Sanya 572000,Hainan,China;Sanya Central Hospital,The Third People's Hospital of Hainan Province,Sanya 572000,Hainan,China)

机构地区：[1]三亚市人民医院,海南三亚572000 [2]三亚中心医院,海南省第三人民医院,海南三亚572000

出　　处：《中华中医药学刊》2021年第10期70-73,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家中医药管理局中医药行业科研项目(2019537)。

摘　　要：目的分析实脾饮合软肝煎治疗脾肾阳虚型肝硬化腹水的临床效果与安全性。方法选取我院2016年1月-2020年1月收治的210例脾肾阳虚型肝硬化腹水患者,随机分为联合组、实脾饮组、软肝煎组,各70例,均给予常规西药治疗,并按照组别分别给予实脾饮合软肝煎、实脾饮、软肝煎治疗。3组患者治疗均持续4周。记录3组患者症状消失时间,并比较3组患者治疗前后肝肾功能、腹围、尿量及体重变化,评价3组临床疗效与安全性。结果联合组腹胀、黄疸、无力、下肢浮肿、少尿、纳呆症状消失时间均低于实脾饮组、软肝煎组,差异有统计学意义(P<0.05)。3组治疗4周后总胆红素(TBIL)、谷丙转氨酶(ALT)、尿素氮(BUN)、肌酐(CRE)均较治疗前下降,白蛋白(ALB)均较治疗前升高;联合组治疗4周后TBIL、ALT、BUN、CRE均低于实脾饮组、软肝煎组,其ALB高于实脾饮组、软肝煎组,差异有统计学意义(P<0.05)。3组治疗4周后腹围、体质量均较治疗前下降,尿量均较治疗前升高;联合组治疗4周后腹围、体质量均低于实脾饮组、软肝煎组,其尿量高于实脾饮组、软肝煎组,差异有统计学意义(P<0.05)。联合组总有效率为91.43%(64/70),高于实脾饮组、软肝煎组的68.57%(48/70)、70.00%(49/70),差异有统计学意义(P<0.05)。3组治疗期间均未见明显不良反应发生。结论实脾饮合软肝煎治疗脾肾阳虚型肝硬化腹水安全性佳,且在改善肝肾功能、缓解临床症状、提高临床疗效方面的作用优于非联合治疗。Objective To analyze the clinical effect and safety of Shipi Decoction(实脾饮)combined with Ruangan Decoction(软肝煎)in the treatment of cirrhotic ascites due to spleen kidney Yang deficiency.s Methods A total of 210 cases of cirrhotic ascites patients with spleen and kidney Yang deficiency in our hospital from January 2016 to January 2020 were selected and ran-domly divided into combination group,Shipi Decoction group and Ruangan Decoction group,with 70 cases in each group.All patients were given conventional western medicine treatment,and were given Shipi Decoction combined with Ruangan Decoction,Shipi Decoction and Ruangan Decoction respectively.The treatment lasted for 4 weeks.The disappearance time of symptoms in the three groups was recorded,and the changes of liver and kidney function,abdominal circumference,urine volume and body weight before and after treatment were compared,and the clinical efficacy and safety of the three groups were evaluated.Results The disappearance time of abdominal distension,jaundice,weakness,edema of lower limbs,oliguria and anorexia in the combi-nation group were lower than those in the Shipi Decoction group or Ruanganjian group(P<0.05).After 4 weeks of treatment,TBIL,ALT,BUN and CRE in three groups were all lower than those before treatment,and ALB was higher than those before treatment.TBIL,ALT,BUN and CRE in combination group were lower than those in the Shipi Decoction group or Ruangan De-coction group after 4 weeks of treatment,and ALB was higher than that in the Shipi Decoction group and Ruangan Decoction group(P<0.05).After 4 weeks of treatment,the abdominal circumference and body weight of the three groups were lower than those before treatment,and the urine volume of the combination group was higher than that of the two groups(P<0.05).The to-tal effective rate of the combination group was 91.43%(64/70),which was higher than 68.57%(48/70)and 70.00%(49/70)of the other two groups(P<0.05).No obvious adverse reactions were observed in the three groups during the treat

关 键 词：实脾饮 软肝煎 脾肾阳虚 肝硬化腹水 

分 类 号：R285.5[医药卫生—中药学]