基于“补肾生髓成肝”综合疗法治疗慢性乙型肝炎肝硬化腹水患者的临床观察  

Clinical observation of"kidney-tonifying and marrow-generating liver-forming"comprehensive therapy for chronic hepatitis B cirrhotic ascites patients

作　　者：兰少波 邵佳微 吴新娟 李瀚旻[2] LAN Shao-bo;SHAO Jia-wei;WU Xin-juan;LI Han-min(Department of Infectious Diseases(Hepatology),Affiliated Hospital of Shaoxing University of Arts and Sciences(Shaoxing Zhejiang,312000),China)

机构地区：[1]绍兴文理学院附属医院感染科(肝病科),浙江绍兴312000 [2]湖北省中医院肝病研究所

出　　处：《中西医结合肝病杂志》2024年第11期976-978,共3页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：2022ZA滋水涵木方促进肝再生的临床研究;2022年度浙江省中医药科学研究基金项目(A类);国家自然科学基金项目(No.81973669);李瀚旻名老中医传承工作室资助项目(鄂卫生计生办通[2018]32号)。

摘　　要：目的:探讨基于“补肾生髓成肝”综合疗法对慢性乙型肝炎肝硬化患者的中医症状积分、肝功能、肝硬度指标等的影响。方法:选取2021年1月至2023年12月在绍兴文理学院附属医院收治的慢性乙型肝炎肝硬化腹水患者60例,随机分为对照组和观察组,每组30例。对照组患者给予西医综合治疗,观察组患者在对照组治疗基础上采用基于“补肾生髓成肝”综合疗法(“补肾生髓成肝”辨证加减,配合西医综合治疗),治疗3个月后,观察两组患者治疗前后中医症状积分、肝功能(白蛋白、胆碱酯酶)、肝硬度、24 h尿量、体重等指标变化情况。结果:观察组患者临床症状积分均较对照组明显降低,差异有统计学意义(P<0.05);治疗后两组患者白蛋白、胆碱酯酶均较治疗前升高,差异有统计学意义(P<0.05);且观察组白蛋白、胆碱酯酶较对照组明显升高,差异有统计学意义(P<0.05)。治疗后两组患者肝硬度值均较治疗前降低,差异有统计学意义(P<0.05);观察组肝硬度值均较对照组明显降低,差异有统计学意义(P<0.05)。结论:基于“补肾生髓成肝”综合疗法治疗慢性乙型肝炎肝硬化腹水患者后可缓解临床症状,改善白蛋白、胆碱酯酶、肝硬度及腹水观察指标,优于单纯西医综合治疗。Objective:To investigate the effects of the comprehensive therapy based on the principle of"tonifying the kidney to generate marrow and transform into liver"on Traditional Chinese Medicine(TCM)symptom scores,liver function,and liver stiffness indicators in patients with chronic hepatitis B cirrhosis.Methods:Sixty patients with hepatitis B cirrhosis and ascites admitted to our hospital from January 2021 to December 2023 were selected and randomly divided into a control group and a treatment group,with 30 cases in each group.The control group received conventional Western medical comprehensive treatment.In contrast,the treatment group received comprehensive therapy based on the principle of"tonifying the kidney to generate marrow and transform into liver"(including TCM syndrome differentiation treatment plus conventional Western medical comprehensive treatment).After three months of treatment,the changes in TCM symptom scores,albumin,cholinesterase,and liver stiffness were observed in both groups before and after treatment.Results:The clinical symptom scores in the treatment group were significantly lower than those in the control group,with statistical significance(P<0.05).After treatment,the levels of albumin and cholinesterase in both groups were significantly increased compared to before treatment,with statistical significance(P<0.05).Moreover,the levels of albumin and cholinesterase in the treatment group were significantly higher than those in the control group,with statistical significance(P<0.05).The liver stiffness values in both groups decreased significantly after treatment compared to before treatment,with statistical significance(P<0.05).The liver stiffness values in the treatment group were significantly lower than those in the control group,with statistical significance(P<0.05).Conclusion:Comprehensive therapy based on the principle of"tonifying the kidney to generate marrow and transform into liver"can alleviate clinical symptoms,improve observation indicators such as albumin,cholinesterase,liver st

关 键 词：补肾生髓成肝 综合疗法 肝硬化 肝功能 肝硬度 滋水涵木 

分 类 号：R575.2[医药卫生—消化系统]