实脾饮加减联合芒硝外敷治疗肝硬化腹水的临床观察  

Clinical efficacy of modified Shipi Yin combined with external use of mirabilite in the treatment of hepatic ascites

作　　者：黄佳丽 曾祥亮 HUANG Jiali;ZENG Xiangliang(Gaoan Hospital of Traditional Chinese Medicine,Jiangxi Province,Gaoan 330800,China)

机构地区：[1]江西省高安市中医院,330800

出　　处：《临床合理用药杂志》2024年第30期24-27,31,共5页Chinese Journal of Clinical Rational Drug Use

基　　金：宜春市指导性科技计划项目(JXYC2024KSA339)。

摘　　要：目的观察实脾饮加减联合芒硝外敷治疗肝硬化腹水的临床疗效,以期为临床治疗提供更多的选择和依据。方法选取2022年3月—2023年3月高安市中医院收治的肝硬化腹水患者70例作为研究对象,采用随机数字表法分为常规治疗组和中药治疗组,各35例。常规治疗组患者入院后均接受常规治疗,中药治疗组在常规治疗组治疗基础上加用实脾饮加减及芒硝外敷治疗。2组患者均接受为期4周的治疗。比较2组治疗前后腹围、肝功能指标[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、白蛋白(Alb)、总胆红素(TBil)]、Child-Pugh评分、健康调查量表36(SF-36)评分及药物不良反应。结果治疗4周后,2组腹围小于治疗前,且中药治疗组小于常规治疗组(P<0.05或P<0.01);常规治疗组Alb水平高于治疗前,TBil水平低于治疗前(P<0.05),中药治疗组ALT、AST、TBil水平低于治疗前及常规治疗组,Alb水平高于治疗前及常规治疗组(P<0.01);常规治疗组SF-36评分高于治疗前(P<0.05),中药治疗组Child-Pugh评分低于治疗前及常规治疗组,SF-36评分高于治疗前及常规治疗组(P<0.01)。2组胃肠道症状、皮肤过敏反应、电解质紊乱、头痛、头晕、肾功能异常、乏力、肝功能异常发生率比较,差异无统计学意义(P>0.05)。结论实脾饮加减联合芒硝外敷治疗肝硬化腹水具有显著优势,不仅能有效减少腹水积聚,改善肝功能,还能提高患者的生活质量,且安全性较高。Objective To analyze the clinical efficacy of modified Shipi Yin combined with external use of mirabilite in the treatment of hepatic ascites effusion,in order to provide more choices and basis foundation for clinical treatment.Methods Seventy patients with hepatic ascites effusion admitted to Gaoan Hospital of Traditional Chinese Medicine from March 2022 to March 2023 were selected,and they were divided into the conventional group and the TCM group by the randomized numerical table method,each with 35 cases.Patients in the conventional group were received conventional treatment after admission,while those in the TCM group were treated with the modified Shipi Yin on the basis of the treatment of the conventional group.The patients in the two groups underwent treatment for a period of 4 weeks.Abdominal circumference,liver function indexes(ALT,AST,Alb,TBil),Child-Pugh score,SF-36 score,and adverse drug reactions were compared between the two groups.Results After 4 weeks of treatment,abdominal circumference of the two groups was smaller than that before treatment,and the TCM group was smaller than that of the conventional group(P<0.05 or P<0.01);Alb level of the conventional group was higher than that before treatment,and the TBil level was lower than that before treatment(P<0.05),and levels of ALT,AST,and TBil in the TCM group were lower than those before treatment and the conventional group,and the Alb level was higher than that before treatment and the conventional group(P<0.01).SF-36 score in the conventional group was higher than that before treatment(P<0.05),Child-Pugh score of the TCM group was lower than that before treatment and conventional group,and SF-36 score was higher than that before treatment and conventional group(P<0.01).There was no significant difference of incidence rate of gastrointestinal symptoms,skin allergic reactions,electrolyte disorders,headache,dizziness,renal function abnormality,malaise,or abnormalities of liver function between the two groups(P>0.05).Conclusion The treatment of hepa

关 键 词：肝硬化 腹水 实脾饮加减 芒硝 中西医结合 肝功能 CHILD-PUGH评分 

分 类 号：R259[医药卫生—中西医结合]