自拟化瘀利水、益气疏肝方联合常规西药治疗乙肝肝硬化腹水的临床观察

Effect of Huayu Lishui and Yiqi Shugan prescription combined with conventional western medicine in the treatment of ascites with liver cirrhosis

目的观察自拟化瘀利水、益气疏肝方联合常规西药治疗乙肝肝硬化腹水的临床效果。方法选取2013年1月~2015年6月我院收治的110例乙肝肝硬化腹水患者,随机分为联合治疗组和常规西药治疗组（n=55）,联合治疗组患者在常规西药治疗基础上加用自拟化瘀利水、益气疏肝方煎水口服。疗程均为1个月,随访6个月。检测丙氨酸氨基转移酶（ALT）、天门冬酸氨基转移酶（AST）、白蛋白（Alb）及总胆红素（TBil）水平;观察患者腹胀、食欲不振、乏力、少尿、下肢水肿和黄疸等症状和体征,以及腹围值和24 h尿量变化,治疗后评价临床疗效。结果与治疗前相比,治疗后两组患者出现腹胀、食欲不振、乏力、少尿、下肢水肿和黄疸等症状和体征的病例数均明显减少;患者腹围值也减小,同时24 h尿量增多;ALT、AST、Alb和TBil指标明显改善,两组间比较,上述症状和体征及实验室指标,联合治疗组均显著优于常规西药治疗组（P〈0.05）。治疗总有效率组间比较,联合治疗组高于常规西药治疗组（89.09%对74.55%,P〈0.05）;随访6个月的复发率,联合治疗组低于西药组（10.91%对23.64%,P〈0.05）。结论自拟化瘀利水、益气疏肝方联合常规西药治疗,可有效改善乙肝肝硬化腹水患者主要症状和体征,以及肝功能等实验室指标,且总有效率提高,远期复发率降低,值得临床推广。

Objective To investigate the effect of the Huayu Lishui and Yiqi Shugan prescription combined with conventional western medicine in the treatment of ascites with liver cirrhosis.Methods A total of 110 objects diagnosed with cirrhoticascites post-hepatitis B in our hospital from 2013 January to 2015 June were selected and assigned into combined group and western medicine group.Western medicine group received conventional western medicine.The combined group was treated with Huayu Lishui and Yiqi Shugan prescription in addition to conventional western medicine treatment,the course of treatment was one months,and six months were followed up.The levels of ALT,AST,Alb and TBil were detected.Abdominal distension,fatigue,oliguria,loss of appetite,edema of lower limbs and jaundice were observed.In addition,the treatment effect of two groups was determined.Results After treatment,the number of patients with abdominal distension,fatigue,oliguria,loss of appetite,edema of lower limbs and jaundice was decreased,and the number of combined group was better than that in western medicine group（P〈0.05）;the abdominal circumference were decreased and 24 h urine volume were increased in both groups,but the combined group was improved obviously than that in western medicine group（P〈0.05）;the levels of ALT,AST,Alb and TBil were improved in both groups,but the combined group improved more obviously（P〈0.05）.Compared with the western medicine group（74.55%）,the total effective rate（89.09%） was higher and the recurrence rate was lower（10.91%vs 23.64%,P〈0.05） in the combined group.Conclusion Huayu Lishui and Yiqi Shugan prescription combined with western medicine can improve the symptoms and liver function of ascites patients with liver cirrhosis,the total effective rate is improved,and the long-term recurrence rate is decreased.It is worth to be popularized and applied in clinic.