利水消癥汤治疗脾肾阳虚型肝硬化腹水的临床疗效及对肝功能恢复的影响
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摘要
目的:观察利水消癥汤治疗脾肾阳虚型肝硬化腹水患者的临床疗效。方法:将110例肝硬化腹水患者,随机分为2组,每组各55例。对照组患者给予常规西药治疗,观察组患者在对照组治疗的基础上给予利水消癥汤治疗,每日1剂,两组14天为1疗程,连续治疗2疗程。观察治疗前后两组患者肝功能指标、基本临床特征、影像学指标;比较两组患者临床症状消失时间和临床疗效。结果:治疗后两组患者ALT、TBIL、AST、VEGF及ET-1较治疗前显著降低(P<0.05),ALB则较治疗前显著升高(P<0.05),观察组较对照组变化幅度显著(P<0.05);治疗后两组患者的腹围及体质量明显降低,24小时尿量显著增多,并且观察组较对照组改善显著,两组比较有统计学意义(P<0.05);治疗后观察组的腹水深度、门静脉、脾静脉主干内径及脾脏厚度改善程度较对照组明显,两组比较有统计学意义(P<0.05)。观察组患者各项临床分级评分显著低于对照组(P<0.05);观察组患者的临床症状消退时间明显少于对照组,两组比较有统计学意义(P<0.05)。观察组的临床总有效率显著高于对照组,两组比较有统计学意义(P<0.05)。结论:利水消癥汤治疗脾肾阳虚型肝硬化腹水临床疗效确切,值得临床推广使用。
Objective:To observe the clinical efficacy of Lishui Xiaozheng Decoction in treating cirrhosis and ascites due to deficiency of spleen and kidney.Methods:110 patients with ascites due to cirrhosis were randomly divided into 2 groups,55 cases in each group.The patients in the controlled group were treated with conventional western medicine.The patients in the observation group were treated with Lishui Xiaozheng Decoction on the basis of the controlled group,1 doses per day,two groups of 14 d as 1 courses,and continuous treatment for 2 courses of treatment.The liver function indexes,basic clinical characteristics and imaging indexes of the two groups were observed before and after treatment.The clinical symptoms disappeared time and clinical efficacy of the two groups were compared.Results:After treatment,ALT,TBIL,AST,VEGF and ET-1 were significantly lower than before treatment(P < 0.05),ALB was significantly higher than before treatment(P < 0.05),and the change of the observation group was significantly higher than that of the controlled group(P < 0.05).The abdominal circumference and body mass of the two groups were significantly lower,and the 24 h urine volume increased significantly after the treatment,and the observation was observed in the two groups.Compared with the controlled group,the improvement of the two groups was statistically significant(P < 0.05).The improvement of the ascites depth,the portal vein,the main trunk diameter of the splenic vein and the thickness of the spleen in the observation group after treatment was significant compared with the controlled group,and the two groups were statistically significant(P < 0.05).The clinical grading scores of the patients in the observation group were significantly lower than those in the controlled group(P < 0.05),and the clinical symptom subsiding time of the observation group was significantly less than that of the controlled group,and the two groups were statistically significant(P < 0.05).The total effective rate of the observation group was significantly higher than that of the controlled group,and the two groups had statistical significance(P < 0.05).Conclusion:Lishui Xiaozheng Decoction is effective in treating cirrhosis and ascites due to deficiency of Spleen Yang and kidney Yang,and is worthy of clinical application.
Objective:To observe the clinical efficacy of Lishui Xiaozheng Decoction in treating cirrhosis and ascites due to deficiency of spleen and kidney.Methods:110 patients with ascites due to cirrhosis were randomly divided into 2 groups,55 cases in each group.The patients in the controlled group were treated with conventional western medicine.The patients in the observation group were treated with Lishui Xiaozheng Decoction on the basis of the controlled group,1 doses per day,two groups of 14 d as 1 courses,and continuous treatment for 2 courses of treatment.The liver function indexes,basic clinical characteristics and imaging indexes of the two groups were observed before and after treatment.The clinical symptoms disappeared time and clinical efficacy of the two groups were compared.Results:After treatment,ALT,TBIL,AST,VEGF and ET-1 were significantly lower than before treatment(P < 0.05),ALB was significantly higher than before treatment(P < 0.05),and the change of the observation group was significantly higher than that of the controlled group(P < 0.05).The abdominal circumference and body mass of the two groups were significantly lower,and the 24 h urine volume increased significantly after the treatment,and the observation was observed in the two groups.Compared with the controlled group,the improvement of the two groups was statistically significant(P < 0.05).The improvement of the ascites depth,the portal vein,the main trunk diameter of the splenic vein and the thickness of the spleen in the observation group after treatment was significant compared with the controlled group,and the two groups were statistically significant(P < 0.05).The clinical grading scores of the patients in the observation group were significantly lower than those in the controlled group(P < 0.05),and the clinical symptom subsiding time of the observation group was significantly less than that of the controlled group,and the two groups were statistically significant(P < 0.05).The total effective rate of the observation group was significantly higher than that of the controlled group,and the two groups had statistical significance(P < 0.05).Conclusion:Lishui Xiaozheng Decoction is effective in treating cirrhosis and ascites due to deficiency of Spleen Yang and kidney Yang,and is worthy of clinical application.
引文
[1] 邓杨,陈治莉,胡蓉.中药脐贴联合苓桂术甘汤内服对脾肾阳虚证肝硬化腹水患者肝功能及腹水消退的影响[J].四川中医,2017,35(01):91～94
[2] 庞雪花.维肝福泰片联合恩替卡韦治疗活动性代偿期乙型肝炎肝硬化的疗效观察[J].现代药物与临床,2018,33(04):871～875
[3] 王亚红,吉兴旺,陈昕雨,等.七消饮颗粒治疗肝硬化腹水的临床研究[J].中国中医药现代远程教育,2017,15(24):76～78
[4] 胡景岚.六味五灵片联合复方甘草酸苷治疗活动性慢性乙型肝炎肝硬化的疗效观察[J].现代药物与临床,2017,32(10):1908～1912
[5] 陈冻伢,熊静芳,徐燕芳,等.肝糖异方通过上调肝脏IRS2/PI3K信号通路改善肝硬化大鼠的胰岛素抵抗[J].中华中医药学刊,2018,36(04):883～886
[6] 李桂珍,付亚,胡伟,等.败黄肝宁合剂联合丁二磺酸腺苷蛋氨酸肠溶片分型论治慢性乙型肝炎肝硬化黄疸的疗效观察[J].河北中医,2018,40(01):78～82
[7] 张声生,王宪波,江宇泳.肝硬化腹水中医诊疗专家共识意见(2017)[J].中华中医药杂志,2017,32(07):3065～3068
[8] 史丽萍.基于《黄帝内经》臌胀理论分析肝硬化腹水的中医诊治[J].中医临床研究,2017,9(21):33～35
[9] 张健,刘海平,汤继军.温阳健脾汤加减治疗乙肝肝硬化顽固性腹水临床研究[J].世界科学技术-中医药现代化,2017,19(10):1666～1670
[10] 杨辰,王达建,唐三亮.决水汤加减治疗肝硬化腹水临床疗效和安全性分析[J].四川中医,2016,34(08):113～116
[11] 刘娟.中药内服外敷治疗肝硬化腹水脾阳虚证疗效观察[J].实用中医药杂志,2017,33(03):240
[2] 庞雪花.维肝福泰片联合恩替卡韦治疗活动性代偿期乙型肝炎肝硬化的疗效观察[J].现代药物与临床,2018,33(04):871～875
[3] 王亚红,吉兴旺,陈昕雨,等.七消饮颗粒治疗肝硬化腹水的临床研究[J].中国中医药现代远程教育,2017,15(24):76～78
[4] 胡景岚.六味五灵片联合复方甘草酸苷治疗活动性慢性乙型肝炎肝硬化的疗效观察[J].现代药物与临床,2017,32(10):1908～1912
[5] 陈冻伢,熊静芳,徐燕芳,等.肝糖异方通过上调肝脏IRS2/PI3K信号通路改善肝硬化大鼠的胰岛素抵抗[J].中华中医药学刊,2018,36(04):883～886
[6] 李桂珍,付亚,胡伟,等.败黄肝宁合剂联合丁二磺酸腺苷蛋氨酸肠溶片分型论治慢性乙型肝炎肝硬化黄疸的疗效观察[J].河北中医,2018,40(01):78～82
[7] 张声生,王宪波,江宇泳.肝硬化腹水中医诊疗专家共识意见(2017)[J].中华中医药杂志,2017,32(07):3065～3068
[8] 史丽萍.基于《黄帝内经》臌胀理论分析肝硬化腹水的中医诊治[J].中医临床研究,2017,9(21):33～35
[9] 张健,刘海平,汤继军.温阳健脾汤加减治疗乙肝肝硬化顽固性腹水临床研究[J].世界科学技术-中医药现代化,2017,19(10):1666～1670
[10] 杨辰,王达建,唐三亮.决水汤加减治疗肝硬化腹水临床疗效和安全性分析[J].四川中医,2016,34(08):113～116
[11] 刘娟.中药内服外敷治疗肝硬化腹水脾阳虚证疗效观察[J].实用中医药杂志,2017,33(03):240