扶脾利水消鼓方结合中医辨证施膳对乙型病毒性肝炎肝硬化腹水肝功能、营养指数的影响  

Effect of Fupi Lishui Xiaogu Recipe(扶脾利水消鼓方)Combined with TCM Syndrome Differentiation on Liver Function and Nutrition Index of Patients with Ascites of Liver Cirrhosis

作　　者：胡秀娟 张丽 王燕 吕竹节 张佳 杨瑞 王龙 仝高成 HU Xiujuan;ZHANG Li;WANG Yan;LYU Zhujie;ZHANG Jia;YANG Rui;WANG Long;TONG Gaocheng(Yuncheng Central Hospital,Yuncheng 044000,Shanxi,China)

机构地区：[1]运城市中心医院,山西运城044000

出　　处：《中华中医药学刊》2024年第7期193-196,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：山西省中医药管理局项目(2019ZYYC063)。

摘　　要：目的评价扶脾利水消鼓方结合中医辨证施膳对乙型病毒性肝炎(简称乙肝)肝硬化腹水患者肝功能、营养指数的影响。方法以2020年7月—2022年7月医院收治的乙肝肝硬化腹水患者92例为研究对象,依据随机对照法将患者分为研究组和参照组,每组46例。参照组采用内科常规治疗,入院后卧床休息,饮食以摄入低盐、低脂、优质蛋白为主,采用利尿剂以利尿消肿,并给予保肝、抗病毒等治疗。研究组在参照组治疗的基础上,口服扶脾利水消鼓方结合中医辨证施膳治疗。两组持续治疗3个月。比较两组治疗前后肝郁脾虚证的中医证候积分,比较治疗总有效率,比较两组患者治疗前后肝功能指标天冬氨酸氨基酸(AST)、谷丙转氨酶(ALT)、总胆红素(T-Bil)和白蛋白(ALB)水平,营养相关指标变化。结果研究组治疗疗效优于参照组(P<0.05);两组治疗后腹胀、纳差、乏力、胁痛和黄疸等中医证候积分较治疗前降低,研究组治疗后腹胀、纳差、乏力、胁痛和黄疸等中医证候积分低于参照组(P<0.05);两组治疗后肝功能指标ALT、AST、T-Bil水平较治疗前降低,ALB水平较治疗前升高,研究组治疗后肝功能指标ALT、AST、T-Bil水平低于参照组,ALB水平高于参照组(P<0.05);两组治疗后BMI、TSF、AMC较治疗前升高,营养风险评分较治疗前降低,组间结果比较显示,研究组治疗后BMI、TSF、AMC水平高于参照组,营养风险评分低于参照组(P<0.05)。结论扶脾利水消鼓方结合中医辨证施膳治疗有助于改善乙肝肝硬化腹水患者的临床症状,增强利尿消除腹水的功效,改善肝功能,促进水液代谢功能的恢复,改善营养状况,提高治疗疗效,值得临床进一步研究探讨。Objective To evaluate the effects of Fupi Lishui Xiaogu Recipe(扶脾利水消鼓方)combined with TCM syndrome differentiation on liver function and nutrition index of patients with ascites of hepatitis B cirrhosis.Methods A total of 92 patients with ascites of hepatitis B cirrhosis admitted to the hospital from July 2020 to July 2022 were selected as the research objects.According to randomized control method,the patients were divided into study group and reference group,with 46 cases in each group.The control group was given routine medical treatment,bed rest after admission,diet with intake of low salt,low fat and high-quality protein,inducing diuresis to reduce edema,liver protection and antiviral treatment.Based on the treatment of the reference group,the study group was treated with Fupi Lishui Xiaogu Recipe combined with TCM syndrome differentiation.Both groups were treated continuously for 3 months.The scores of liver depression and spleen deficiency,the total effective rate,the levels of aspartate amino acids(AST),alanine aminotransferase(ALT),total bilirubin(T-Bil)and albumin(ALB),and the changes of nutrition-related indexes were compared between the two groups before and after treatment.Results The therapeutic effect of the study group was better than that of the control group(P<0.05).After treatment,the scores of abdominal distension,poor eating,fatigue,hypochthic pain and jaundice in both groups were lower than those before treatment.The scores of abdominal distension,poor eating,fatigue,hypochthic pain and jaundice in the study group were lower than those in the control group(P<0.05).After treatment,the levels of ALT,AST and T-Bil in the two groups were lower than those before treatment,while the levels of ALB were higher than those before treatment.The levels of ALT,AST and T-Bil in the study group were lower than those in the control group,while the level of ALB was higher than that in the control group(P<0.05).After treatment,the values of body mass index(BMI),triceps skinfold thickness(TSF)and

关 键 词：扶脾利水消鼓方 中医辨证施膳 乙肝肝硬化腹水 营养指数 影响 

分 类 号：R269.573[医药卫生—中西医结合]