摘要
目的:观察用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、腹水消退的影响。方法:选择2013年5月~2015年2月就诊于我院的脾肾阳虚证肝硬化腹水患者90例为研究对象,随机分为对照组和治疗组各45例。两组患者均给予利尿、护肝、补充白蛋白等常规治疗,对照组患者加用恩替卡韦片内服,治疗组患者则给予中药脐贴联合苓桂术甘汤内服治疗,两组均连续治疗4周。比较临床治疗的有效率,评价中医证候积分,观察治疗过程中肝功能指标变化及腹水的消退情况,检测治疗前后血清中二胺氧化酶(DAO)、乳酸脱氢酶(LDH)及腹水白蛋白梯度(SAAG)水平变化。结果:治疗组、对照组的临床有效率分别为88.9%、64.4%,差异性显著(χ2=7.516,P<0.05);治疗组患者的临床症状经治疗后改善更明显,其主要中医证候积分显著低于对照组患者,差异性显著(P<0.05);治疗组患者经治疗后的肝功能指标谷草转氨酶(AST)、谷丙转氨酶(ALT)、总胆红素(TBIL)显著低于对照组,而白蛋白(Alb)水平则高于对照组,差异性显著(P<0.05);治疗2周后治疗组患者的腹水消失率与对照组相比明显升高,差异性显著(P<0.05);治疗后治疗组患者的DAO、LDH、SAAG水平显著低于对照组患者,差异性显著(P<0.05)。结论:中药脐贴联合苓桂术甘汤内服治疗脾肾阳虚证肝硬化腹水疗效确切,利于缓解患者的临床症状,提高肝功能,促进腹水的消退,降低DAO、LDH、SAAG水平,值得临床推广运用。
Objective： To investigate the influence of liver function and ascites subsided for treating spleen-kidney Yang-deficiency syndrome liver cirrhosis ascites patients with traditional Chinese medicine navel stick and Linggui Zhugan Decoction. Methods： 90 cases were randomly divided into a controlled group of 45 cases and an observation group of 45 cases from May 2013 to February 2015. Patients in the two groups were given diuresis,protecting liver and albumin supplementation for conventional treatment,patients in the controlled group were treated with entecavir tablets; while patients in the observation group were treated with traditional Chinese medicine navel stick and Linggui Zhugan Decoction,four weeks for treatment. The research was focus on comparing the effectiveness,evaluating the main syndromes points,observing the liver function index change and ascites subsided,and testing the levels of DAO,LDH and SAAG. Results： The effective rate of patients in the observation group and the controlled group respectively were 88. 9% and 64. 4%,the difference was significant（ χ2 = 7. 516,P〈0. 05）; the improvement of clinical symptoms for the observation group patients was more obvious compared with the controlled group,the symptoms scores were lower than that of the controlled group,the difference was significant（ P〈0. 05）; the levels of AST,ALT and TBIL after treatment were lower than that of the controlled group,while the Alb level was higher than that of the controlled group,the difference was significant（ P〈0. 05）; the ascites disappear rates of the observation group patients were higher than that of the controlled group after treatment for 2weeks,the difference was significant（ P〈0. 05）; the levels of DAO,LDH and SAAG and TBIL after treatment were lower than that of the controlled group,the difference was significant（ P〈0. 05）. Conclusion： The therapyhas the satisfactory clinical effect. It can effectively alleviate the uncomfortable symptom,improve the liver function,promote the ascites subsided,and lower the levels of the DAO,LDH and SAAG,is worthy of clinical promotion.
出处
《四川中医》
2017年第1期91-94,共4页
Journal of Sichuan of Traditional Chinese Medicine
关键词
肝硬化腹水
中药脐贴
苓桂术甘汤
脾肾阳虚证
肝功能
腹水消退
Liver cirrhosis ascites
Traditional Chinese medicine navel stick
Linggui Zhugan Decoction
Spleen-kidney Yang-deficiency Syndrome
Liver function
Ascites subsided
