补中治湿汤加减治疗轻中度肝硬化腹水患者的临床疗效研究  

Clinical Effect of Modified Buzhong Zhishi Decoction on Patients withMild and Moderate Cirrhosis with Ascites

作　　者：吉春阳 王振东 马海丽 JI Chun-yang;WANG Zhen-dong;MA Hai-li(Department of Gastroenterology and Hepatobiliary Pancreatology,Zhumadian Central Hospital,Zhumadian 463000,China;Gastroscopy Room,the First People's Hospital of Zhumadian,Zhumadian 463000,China)

机构地区：[1]驻马店市中心医院消化二肝胆胰内科,驻马店463000 [2]驻马店市第一人民医院胃镜室,驻马店463000

出　　处：《中国合理用药探索》2024年第4期102-109,共8页Chinese Journal of Rational Drug Use

基　　金：河南省医学科技攻关计划项目(SBGJ202000258)。

摘　　要：目的:探讨补中治湿汤加减治疗轻中度肝硬化腹水患者的临床疗效。方法:选取2020年1月~2022年12月期间于某院治疗的105例轻中度肝硬化腹水患者作为研究对象,根据随机数字表法分为对照组(n=52,自行退出1例)和观察组(n=53,自行退出2例)。对照组患者给予常规西医治疗,观察组患者在对照组治疗基础上给予补中治湿汤加减治疗,两组均连续治疗1个月。比较两组患者血管内皮损伤指标[内皮素-1(ET-1)、内毒素]、炎症因子[肿瘤坏死因子-α(TNF-α)、细胞间黏附分子-1(ICAM-1)]、氧化应激指标[谷胱甘肽过氧化物酶(GSH-Px)、对氧磷酯酶1(PON-1)、丙二醛(MDA)]、肝纤维化指标[透明质酸(HA)、层粘连蛋白(LN)]、肿瘤标志物[甲胎蛋白(AFP)]、肝功能指标[谷草转氨酶(AST)、谷丙转氨酶(ALT)]、血清-腹水白蛋白梯度(SAAG)、门静脉血流量、门静脉主干内径、24h尿量、腹围、腹水深度、临床疗效及不良反应发生情况。结果:治疗后,两组患者ET-1、内毒素、TNF-α、ICAM-1水平均降低(P<0.05),且观察组低于对照组(P<0.05);两组患者GSH-Px、PON-1水平均升高(P<0.05),且观察组高于对照组(P<0.05);两组患者MDA水平均降低(P<0.05),且观察组低于对照组(P<0.05);两组患者HA、LN、AFP、AST、ALT水平均降低(P<0.05),且观察组低于对照组(P<0.05);两组患者门静脉血流量、门静脉主干内径均降低(P<0.05),且观察组低于对照组(P<0.05);两组患者SAAG、腹围、腹水深度均降低(P<0.05),且观察组低于对照组(P<0.05);两组患者24h尿量均增加(P<0.05),且观察组高于对照组(P<0.05);观察组患者治疗总有效率(98.04%)高于对照组(88.24%,P<0.05)。两组患者治疗期间均未发生明显不良反应。结论:在常规治疗基础上联合补中治湿汤加减治疗轻中度肝硬化腹水患者临床疗效较佳,可降低患者内毒素水平,减轻炎症反应及氧化应激损伤,改善血管内皮功能、肝功能及门静�Objective:To investigate the clinical effect of modified Buzhong Zhishi decoction on patients with mild to moderate cirrhosis with ascites.Methods:A total of 105 patients with mild to moderate cirrhosis with ascites,treated at a hospital from January 2020 to December 2022,were selected as the study subjects,and were assigned into the control group(n=52,1 patient withdrew voluntarily)and the observation group(n=53,2 patients withdrew voluntarily)using a random number table method.Patients in the control group were given conventional western medicine treatment,and patients in the observation group were given modified Buzhong Zhishi decoction in addition to the control group.Both groups underwent treatment continuously for 1 month.Vascular endothelial damage index[endothelin-1(ET-1)and endotoxin],inflammatory factor[tumor necrosis factor-α(TNF-α),intercellular adhesion molecule-1(ICAM-1)],oxidative stress index[glutathione peroxidase(GSH-Px),paraoxonase-1(PON-1),malondialdehyde(MDA)],liver fibrosis index[hyaluronic acid(HA),laminin(LN)],tumor marker[alpha-fetoprotein(AFP)],liver function index[aspartate transaminase(AST),alanine transaminase(ALT)],serum-ascites albumin gradient(SAAG),portal vein blood flow,portal main internal diameter,24h urine volume,abdominal circumference,ascites depth,clinical efficacy and adverse reactions were compared between the two groups.Results:Following treatment,the levels of ET-1,endotoxin,TNF-αand ICAM-1 decreased in both groups(P<0.05),with significantly lower levels in the observation group compared to the control group(P<0.05).The levels of GSH-Px and PON-1 increased in both groups(P<0.05),with notably higher levels in the observation group than in the control group(P<0.05).The MDA levels decreased in both groups(P<0.05),with the observation group showing lower levels than in the control group(P<0.05).The levels of HA,LN,AFP,AST and ALT decreased in both groups(P<0.05),with the observation group showing lower levels than the control group(P<0.05).Portal vein blood flow and port

关 键 词：补中治湿汤加减 肝硬化腹水 内毒素 炎症 氧化应激 血管内皮功能 

分 类 号：R575.2[医药卫生—消化系统]