脐透利水贴辅助治疗肝硬化难治性腹水血瘀水停证患者36例临床观察  

Umbilical Venting and Urination Promoting Patch As Adjuvant Treatment for the Refractory Ascites of Cirrhosis with Blood Stasis and Water Retention in 36 Cases

作　　者：陈虹秀 吴雨泉 刘光伟 CHEN Hongxiu;WU Yuquan;LIU Guangwei(Henan University of Chinese Medicine,Zhengzhou,450046;The First Affiliated Hospital of Henan University of Chinese Medicine)

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：《中医杂志》2023年第14期1462-1468,共7页Journal of Traditional Chinese Medicine

基　　金：河南省特色骨干学科中医学学科建设项目(STGZYXKY-2020017);国家中医药管理局第五批全国中医临床优秀人才研修项目(国中医药人教函[2022]1号)。

摘　　要：目的观察脐透利水贴辅助治疗肝硬化难治性腹水血瘀水停证的疗效及安全性。方法72例肝硬化难治性腹水血瘀水停证患者随机分为治疗组及对照组各36例。对照组采用西医常规基础治疗,治疗组在对照组基础上加用脐透利水贴神阙穴外敷,每日1次,每次1~2h,每周6次。两组均治疗14天。治疗前后比较两组患者彩色超声腹水分度分值评分、腹围、体重、24h尿量、中医症状量化积分,检测肝功能相关指标[总胆红素(TBiL)、丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、白蛋白(ALB)],治疗后判定中医证候疗效、临床疗效及安全性。结果与本组治疗前比较,两组患者治疗后中医症状量化积分、TBiL、ALT、AST、彩色超声腹水分度值评分、体重及腹围均明显降低,ALB水平明显升高,24h尿量明显增加(P<0.05或P<0.01)。两组治疗后组间比较,治疗组在降低中医症状量化积分、TBiL、ALT、AST、彩色超声腹水分度值评分、体重及腹围,升高ALB及增加24h尿量方面明显优于对照组(P<0.05或P<0.01)。治疗组中医证候疗效总有效率(88.89%)高于对照组(58.33%,P<0.01);治疗组临床疗效总有效率(94.44%)亦高于对照组(72.22%,P<0.01)。两组患者生命体征平稳,未发生明显不良事件。结论脐透利水贴辅助治疗肝硬化难治性腹水血瘀水停证可显著改善临床症状、彩色超声腹水分度值及肝功能,提高临床疗效且安全性好。Objective To observe the efficacy and safety of umbilical venting and urination promoting patch as adjuvant treatment for refractory ascites of cirrhosis with blood stasis and water retention syndrome.Methods A total of 72 patients with refractory ascites of cirrhosis and syndrome of blood stasis and water retention were randomly divided into the treatment group(36 cases)and control group(36 cases).The control group was treated with conven-tional western medicine,and the treatment group was additionally given umbilical venting and urination promoting patch at Shenque(CV 8),once daily,1-2 hours per time,six times weekly for 14 days.Color ultrasound ascites score,abdominal circumference,body weight,24-hour urine volume,traditional Chinese medicine(TCM)symptom score were compared before and after treatment in the two groups,and liver function-related indicators including total bilirubin(TBiL),alanine aminotransferase(ALT),aspartate aminotransferase(AST),and albumin(ALB)were de-tected;after treatment,the syndrome efficacy,clinical efficacy and safety of the two groups were judged.Results The TCM symptom score,TBiL,ALT,AST,color ultrasound ascites score,body weight and abdominal circumfer-ence decreased,while ALB and 24-hour urine volume increased in both groups after treatment(P<0.05 or P<O.O1).The treatment group was better than the control group in reducing TCM symptom score,TBiL,ALT,AST,color ultrasound ascites score,weight,and abdominal circumference,as well as increasing ALB and 24-hour urine volume(P<0.05 or P<0.01).The syndrome efficacy and clinical efficacy rate of the treatment group were 88.89%and 94.44%,respectively,higher than 58.33%and 72.22%of the control group(P<0.01).The vital signs of the patients in the two groups were stable,and no obvious adverse events occurred.Conclusion Umbilical venting and urination promoting patch as adjuvant treatment for refractory ascites of liver cirrhosis with blood stasis and water re-tention syndrome can significantly improve clinical symptom,color ultrasound ascites

关 键 词：肝硬化 难治性腹水 脐透利水贴 血瘀水停证 彩色超声 腹水分度值 肝功能 

分 类 号：R259[医药卫生—中西医结合]