软肝利水方联合逐水方敷脐治疗脾虚水停型肝硬化难治性腹水的临床研究  

Clinical observation of Ruangan Lishui prescription combined with spreading umbilicus by Zhuishui prescription on refractory ascites due to hepatocirrhosis of spleen deficiency and water retention syndrome

作　　者：谢露 陈虹秀 郝君玉 范文艳 刘光伟 XIE Lu;CHEN Hong-xiu;HAO Jun-yu;LIU Guang-wei(Henan University of traditional Chinese Medicin,Zhengzhou Henan,450046,China;不详)

机构地区：[1]河南中医药大学,河南郑州450046 [2]河南中医药大学第一附属医院

出　　处：《中西医结合肝病杂志》2023年第3期220-223,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：河南省特色骨干学科中医学学科建设项目(No.STG-ZYXKY-2020017)。

摘　　要：目的:观察软肝利水方联合逐水方脐敷治疗对脾虚水停型肝硬化难治性腹水患者的肝功能、门静脉主干内径(Dpv)、T细胞亚群的影响。方法:将134例肝硬化难治性腹水患者随机分为观察组(67例)和对照组(67例)。对照组患者予西医内科常规治疗联合逐水方敷脐,观察组患者在对照组治疗基础上加服软肝利水方汤剂,疗程为8周。观察两组患者治疗前后中医证候积分、体质量、腹围、24 h尿量、肝功能、T细胞亚群、彩超腹水暗区最大深度、门静脉主干内径(Dpv)、凝血功能、电解质的变化,评价综合疗效。结果:观察组患者总有效率为86.37%高于对照组的66.15%(P<0.05)。治疗后两组患者中医证候积分、体质量、腹围、24 h尿量、肝功能指标、腹水暗区最大深度、门静脉主干内径、凝血功能指标较治疗前均有改善,且观察组改善程度均优于对照组(均P<0.05);两组患者治疗后电解质较治疗前无明显变化(P>0.05),未增加患者电解质紊乱的发生。结论:软肝利水方联合逐水方脐敷治疗脾虚水停型肝硬化难治性腹水可提高临床有效率,且安全可靠。Objective:To evaluate the effects of Ruangan Lishui prescription combined with spreading umbilicus by Zhuishui prescription on liver function, main portal vein diameter(Dpv), and T-cell subsets in patients with refractory ascites due to cirrhosis with spleen deficiency and water retention syndrome.Methods:A total of 131 cirrhotic patients with refractory ascites was randomly divided into an observation group(66 patients) and a control group(65 patients). The control group was given routine treatment in western medicine, and the observation group was given a Ruangan Lishui prescription combined with spreading umbilicus by Zhuishui prescription on the basis of the control group. The course of treatment was eight weeks. The TCM syndrome scores, body mass, abdominal circumference, 24h urine volume, liver function, T cell subsets, maximum depth of ascites dark zone on color ultrasound, Dpv, coagulation function, and electrolyte changes were observed before and after treatment in both groups to evaluate the comprehensive efficacy.Results:The overall response rate of 86. 37% in the observation group was higher than the 66. 15% in the control group(P< 0. 05). After treatment, TCM syndrome scores, body mass, abdominal circumference, 24 h urine volume, liver function indicators, maximum depth of the dark zone of ascites, Dpv, and coagulation function indicators were improved in both groups compared with before treatment, and the degree of improvement in the observation group was better than that in the control group(P< 0. 05). Moreover, the electrolytes after treatment in both groups did not change significantly compared with those before treatment(P> 0. 05) and did not increase the occurrence of electrolyte imbalance in patients.Conclusion:Ruangan Lishui prescription combined with spreading umbilicus by Zhuishui prescription for the treatment of refractory ascites of spleen deficiency and water retention syndrome can improve the clinical effective rate, and it is safe and reliable.

关 键 词：软肝利水方 中医外治 肝硬化 难治性腹水 

分 类 号：R575.2[医药卫生—消化系统]