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纸质出版日期:2015
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李延玲, 翟玉峰, 张怀宏, 等. 中医综合疗法治疗脾肾阳虚水停证肝硬化腹水60例临床观察[J]. 中国实验方剂学杂志, 2015,21(16):179-182.
LI Yan-ling, ZHAI Yu-feng, ZHANG Huai-hong, et al. Clinical Observation of Comprehensive Traditional Chinese Medicine Therapy in Treating 60 Cases with Hepatocirrhosis Ascites (Spleen and Kidney Yang Deficiency and Water Retention Symptoms)[J]. Chinese journal of experimental traditional medical formulae, 2015, 21(16): 179-182.
李延玲, 翟玉峰, 张怀宏, 等. 中医综合疗法治疗脾肾阳虚水停证肝硬化腹水60例临床观察[J]. 中国实验方剂学杂志, 2015,21(16):179-182. DOI: 10.13422/j.cnki.syfjx.2015160179.
LI Yan-ling, ZHAI Yu-feng, ZHANG Huai-hong, et al. Clinical Observation of Comprehensive Traditional Chinese Medicine Therapy in Treating 60 Cases with Hepatocirrhosis Ascites (Spleen and Kidney Yang Deficiency and Water Retention Symptoms)[J]. Chinese journal of experimental traditional medical formulae, 2015, 21(16): 179-182. DOI: 10.13422/j.cnki.syfjx.2015160179.
目的: 观察加味附子理中汤内服、神阙穴贴敷和艾灸的综合疗法治疗肝硬化腹水(脾肾阳虚水停证)的临床疗效。 方法: 将118例患者随机按数字表法分为对照组58例和观察组60例。对照组卧床休息
减少钠盐摄入
限制患者液体输入量;纠正水、电解质紊乱和酸碱平衡;给予保肝、利尿等处理。观察组在对照组治疗的基础上给予加味附子理中汤内服、神阙穴贴敷和艾灸的中医综合疗法。两组疗程均为4周。进行治疗前后脾肾阳虚水停证评分
采用Child-Pugh分级评价肝功能
检测治疗前后丙氨酸氨基转移酶(ALT)
天门冬氨酸氨基转移多酶(AST)
总胆红素(TBIL)和血清白蛋白(ALB)水平;采用B超检查腹水程度
测量治疗前后体重、腹围等。 结果: 经Ridit分析
观察组综合疗效优于对照组(P <0.05)
观察组中医证候疗效优于对照组;治疗后观察组ALT
AST
TBIL水平低于对照组(P <0.05
P <0.01);治疗后ALB水平组间比较差异无统计学意义;治疗后观察组脾肾阳虚证和Child-Pugh评分均低于对照组(P <0.01)
体重轻于对照组(P <0.05)
腰围小于对照组(P <0.05)
24 h尿量多于对照组(P <0.01)。 结论: 在西医常规治疗的基础上
中医综合疗法能改善肝硬化腹水(脾肾阳虚水停证)患者的肝功能
减轻临床症状、体征
促进腹水的消退
其综合疗效和中医证候疗效均优于单纯西医治疗。
Objective: To observe the clinical effect of the comprehensive therapy of intake of Jiawei Fuzi Lizhong decoction
application on Shenque acupoint and moxibustion in treating hepatocirrhosis ascites (spleen and kidney yang deficiency and water retention symptoms). Method: Totally 118 patients were randomly divided into the control group (58 cases) and the observation group (60 cases). The control group stayed in bed
took less sodium and limited liquid infusion to balance water
electrolyte and acid-base value
and received therapies for liver protection and diuresis. Based on the therapies of the control group
the observation group additionally received the comprehensive traditional Chinese medicine therapy of intake of Jiawei Fuzi Lizhong decoction
application on Shenque acupoint and moxibustion. Both groups were treated for four weeks. Before and after the treatment
the spleen and kidney yang deficiency and water retention symptoms were scored.The liver function was evaluated by Child-Pugh.The levels of glutamic-pyruvic transaminase (ALT)
glutamic oxalacetic transaminase (AST)
total bilirubin (TBIL) and serum albumin (ALB) were detected.Ascites was detected by B ultrasonic.And weight and abdominal perimeter were measured. Result: According to Ridit analysis
the clinical effect in the observation group was higher than that in the control group (P <0.05).The effect in TCM syndromes in the observation group was also higher than that in the control group. After the treatment
the levels of ALT
AST and TBIL in the observation group were lower than that in the control group (P <0.05 or P <0.01)
but with no statistical significance in the ALB level in the inter-group comparison.The observation group showed higher spleen and kidney yang deficiency and Child-Pugh scores (P <0.01) and 24-hour urine volume (P <0.01) but lower weight and abdominal perimeter than that in the control group (P <0.05). Conclusion: Based on the conventional western medicine therapy
the comprehensive traditional Chinese medicine therapy can ameliorate the function of patients with hepatocirrhosis ascites (spleen and kidney Yang deficiency and water retention symptoms)
relieve clinical symptoms and signs and promote the ascites regression
with superior comprehensive efficacy comprehensive traditional Chinese medicine syndrome score than the pure western medicine therapy.
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