外敷、灌肠、辨证分型联合西药治疗乙肝后肝硬化腹水随机平行对照研究

External Treatment,Enema,Syndrome Differentiation with Western Medicine Therapy after Hepatitis b Cirrhosis Ascites Random Parallel Control Study

[目的]观察外敷、灌肠、辨证分型联合西药治疗乙肝后肝硬化腹水疗效。[方法]使用随机平行对照方法,将90例门诊及住院患者按抽签法简单随机分为两组。对照组45例常规西药治疗,利尿药,抗病毒药物,补充白蛋白,保肝。治疗组45例辨证治疗,湿热蕴予茵陈蒿汤(茵陈蒿12g,栀子、大黄各9g);脾肾阳虚予附子理中丸(人参、干姜、白术、附子各10g,炙甘草5g),均1剂/d,水煎200mL,早晚口服;中药外敷,消胀散(甘草、大戟、沉香、大黄、厚朴各12g),磨粉,食醋调糊,敷于脐部,热水袋热敷,12h/次,1次/d;中药灌肠(大黄、厚朴、芒硝各10g),药汁浓缩,加食醋灌肠,30min/次,1次/d;西药治疗同对照组。连续治疗7d为1疗程。观测临床症状、ALT、AST、TBIL、ALB、不良反应。连续治疗3疗程,判定疗效。[结果]治疗组显效30例,有效12例,无效3例,总有效率93.34%。对照组显效16例,有效22例,无效7例,总有效率84.45%。治疗组疗效优于对照组(P<0.05)。肝功能指标两组均有改善(P<0.05),治疗组改善优于对照组(P<0.05)。[结论]外敷、灌肠、辨证联合西药治疗乙肝后肝硬化腹水效果显著,值得推广。

[ Objective ] to obseve the external treatment, enema, syndrome differentiation with western medicine therapy after hepatitis b cirrhosis ascites curative effect. [ Methods ] Using random parallel control method, 90 cases of outpatient and hospitalized patients were randomly divided into two groups according to the draw method. Control group 45 cases of conventional western medicine treatment, diuretic, antiviral drugs, albumin supplementation, protect liver. Treatment group 45 cases of syndrome differentiation treatment, damp and hot accumulate in artemisia capillaris soup （ Yinchengaol2 g, Zhizi, Dahuang 9g） ; In the spleen and kidney Yang deficiency in aconite pill （ Renshen, Ganjiang, Baizhu, Fuzi each 10 g, Zhigancao 5 g）, all agent 1 / d, boiling water 200 ml, oral sooner or later. Chinese medicine external treatment, disperse like expansion （Gancao, Daji, Chenxiang, Dahaung, Houpu 12 g）, flour, vinegar paste, apply navel, hot water bag hot compress, 12 h/times, 1 / d. Traditional Chinese medicine enema （ Dahung, Houpu, Mangxiao every 10 g ）, concentrated juice, add the vinegar enema, 30 rain/times, 1 / d. Western medicine treatment with the control group. Continuous treatment of 7 d for 1 course of treatment. Observation of clinical symptoms, ALT, AST, TBIL, propagated, adverse reactions. Continuous treatment 3 period of treatment, judge curative effect. [ Results ] the treatment group 30 cases had marked effect, 12 cases effective, 3 had no effect, the total effective rate was 93.34%. Control group 16 cases had marked effect, effectively 22 cases, 7 had no effect, the total effective rate was 84.45%. The treatment group curative effect is better than that of control group（ P 〈 0.05 ） . Two groups of liver function index were improved （ P〈0.05 ）, the treatment group is better than that of control group （ P〈 0.05 ） . [ Conclusion ] Gels, enema, syndrome differentiation with western medicine therapy after hepatitis b cirrhosis ascites effect is remarkable, is worth promoting.