透穴针法联合退黄合剂灌肠治疗肝硬化顽固型腹水的临床研究  

Clinical research of refractory ascites of cirrhosis treated with acupoint-penetrating needling technique of acupuncture and enema with tuihuang mixture

作　　者：白佳萌 刘光伟[2] BAI Jia-meng;LIU Guang-wei(First Clinical Medical School of Henan University of Chinese Medicine,Zhengzhou 450099;Department of Gastroenterology,The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450099)

机构地区：[1]河南中医药大学第一临床医学院,郑州450099 [2]河南中医药大学第一附属医院消化科,郑州450099

出　　处：《针刺研究》2022年第1期59-64,共6页Acupuncture Research

基　　金：河南省中医药科学研究重点专项课题(No.2018JDZX109);河南省中医药科学研究专项课题(No.2019ZYBJ04)。

摘　　要：目的:观察透穴针法联合退黄合剂灌肠对肝硬化顽固型腹水患者肝功能,门静脉血流动力学,血浆一氧化氮(NO)、肠源性内毒素(ETM)及干扰素γ(IFN-γ)的影响。方法:将120例肝硬化顽固型腹水患者随机分为观察组和对照组,每组60例(观察组脱落2例,对照组脱落3例)。对照组给予常规西医治疗联合退黄合剂保留灌肠,观察组在对照组基础上给予透穴针法治疗,中脘透水分,水分透气海,气海透关元,关元透中极,疗程均为30 d,共治疗2个疗程。评价两组患者临床疗效,观察两组患者治疗前后体质量、腹围、24 h尿量/周、腹水暗区最大深度、肝功能指标、门静脉血流动力学及血浆NO、ETM及IFN-γ变化。结果:观察组治疗总有效率为81.03%(47/58),高于对照组的63.16%(36/57,P<0.05)。治疗后两组体质量、腹围、腹水暗区最大深度、门静脉主干内径(Dpv)、最大血流速度(Vmax)、静脉血流量(Q)均低于本组治疗前(P<0.05),24 h尿量/周高于本组治疗前(P<0.05),肝功能各指标均明显改善(P<0.05)。观察组治疗后体质量、腹围、腹水暗区最大深度、Dpv、Vmax、Q低于对照组(P<0.05),24 h尿量/周高于对照组(P<0.05),肝功能各指标改善程度高于对照组(P<0.05)。两组治疗后血浆NO、ETM含量均低于治疗前(P<0.05),IFN-γ含量高于治疗前(P<0.05)。观察组治疗后NO、ETM含量低于对照组,IFN-γ含量高于对照组(P<0.05)。结论:透穴针法联合退黄合剂灌肠治疗肝硬化顽固型腹水可有效提高疗效,该作用与其降低内毒素水平,改善门静脉血流动力学,提高细胞免疫功能有关。Objective To observe the effects on liver function,portal hemodynamics,plasma nitric oxide(NO),intestinal endotoxin(ETM)and interferonγ(IFN-γ)treated with acupoint-penetrating needling technique of acupuncture and enema with tuihuang mixture in the patients with refractory ascites of cirrhosis.Methods A total of 120 patients with refractory ascites of cirrhosis were divided randomly into an observation group and a control group,60 cases in each one.In the control group,the routine western medicine treatment was applied in combination with enema with tuihuang mixture.In the observation group,on the base of the treatment as the control group,acupoint-penetrating needling technique of acupuncture was added,Zhongwan(CV12)penetrated toward Shuifen(CV9),CV9 toward Qihai(CV6),CV6 toward Guanyuan(CV4)and CV4 toward Zhongji(CV3)respectively.The duration of treatment was 60 days in both groups.The clinical therapeutic effect was analyzed in the patients of both groups.Before and after treatment,the changes in body mass,abdominal circumference,24 h urine output/week,maximum depth of dark area of ascites,liver function indicators,portal vein hemodynamics,plasma NO,ETM and IFN-γwere observed in the patients of the two groups.Results The total effective rate was 81.03%(47/58)in the observation group,higher than 63.16%(36/57)in the control group(P<0.05).After treatment,in the self-comparison of each group,the levels of body mass,abdominal circumference,the maximum depth of the dark area of ascites,the main portal vein diameter(Dpv),maximum blood flow velocity(Vmax)and venous blood flow(Q)were all lower than those before treatment(P<0.05),24 h urine output/week was higher than that before treatment(P<0.05),and every indicator of liver function was improved(P<0.05).After treatment,the values of body mass,abdominal circumference,the maximum depth of the dark area of ascites,Dpv,Vmax and Q in the observation group were all lower than those in the control group(P<0.05),24 h urine output/week was higher than that in the control gr

关 键 词：肝硬化顽固型腹水 透穴针法 退黄合剂 

分 类 号：R246.1[医药卫生—针灸推拿学]