附子理中汤合五苓散加减治疗乙型肝炎肝硬化伴腹水的疗效  

The curative efficacy of Fuzi Lizhong Decoction combined with Wuling Power in the treatment of hepatitis B cirrhosis with ascites

作　　者：樊冉 李矫捷 FAN Ran;LI Jiaojie(Infection Department,China Rongtong Medical and Health Group Co.,Ltd.Zibo 148 Hospital,255300,China)

机构地区：[1]中国融通医疗健康集团有限公司淄博一四八医院感染科,255300

出　　处：《传染病信息》2024年第6期502-505,共4页Infectious Disease Information

摘　　要：目的探究附子理中汤合五苓散加减治疗乙型肝炎肝硬化伴腹水患者的疗效及对肝脏纤维化、肝功能的影响。方法以中国融通医疗健康集团有限公司淄博一四八医院从2021年5月到2024年5月收治的乙型肝炎肝硬化伴中度腹水的80例患者作为研究对象,按照随机数字表法分为观察组和对照组,每组各40例,对照组采取常规临床内科西药治疗,观察组在常规西药治疗基础上联合应用附子理中汤合五苓散加减。对比2组患者治疗后腹水消退效果、肝脏纤维化指标透明质酸(hyaluronic acid,HA)、Ⅲ型前胶原(type Ⅲ procollagen,PCⅢ)、Ⅳ型胶原(type Ⅳ collagen,Ⅳ-C)、层黏蛋白(laminin,LN)水平、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)及总胆红素(total bilirubin,TBIL)的变化。结果治疗后,观察组患者的临床疗效(80%)高于对照组(57.5%)(P<0.05);观察组患者的肝脏纤维化指标中HA、PCⅢ、Ⅳ-C、LN水平均低于对照组(P均<0.05),血清TBIL、ALT及AST均低于对照组(P均<0.05)。结论针对乙型肝炎肝硬化合并腹水患者采取附子理中汤合五苓散加减治疗,可有效提高临床治疗效果,改善患者肝纤维化指标及肝功能水平,利于患者预后。Objective To investigate the curative effect of Fuzi Lizhong Decoction combined with Wuling SAN in the treatment of hepatitis B cirrhosis with ascites and its influence on liver fibrosis and liver function.Methods A total of 80 patients with hepatitis B cirrhosis and moderate ascites treated from May 2021 to May 2024 were divided into 2 groups according to the random number table method,with 40 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with Fuzi Lizhong Tang combined with Wuling SAN on the basis of conventional Western medicine.The effect of ascites resolution,liver fibrosis index HA,PCⅢ,Ⅳ-C,LN,liver function TBil,ALT and AST were compared between the two groups after treatment.Results The clinical efficacy of the observation group(80%)was higher than that of the control group(57.5%)(P<0.05).After different treatment methods,the levels of HA,PC Ⅲ,Ⅳ-C and LN of liver fibrosis indexes in the observation group were lower than those in the control group(P<0.05).Serum TBIL,ALT and AST in the observation group were lower than those in the control group(P<0.05).Conclusion For patients with hepatitis B cirrhosis complicated with ascites,Fuzi Lizhong Decoction combined with Wuling SAN can effectively improve the clinical therapeutic effect,improve the liver fibrosis index and liver function level of patients,and is beneficial to the prognosis of patients,which is worthy of clinical promotion and adoption.

关 键 词：附子理中汤合五苓散加减 乙型肝炎肝硬化 疗效 肝纤维化 腹水 

分 类 号：R575.2[医药卫生—消化系统]