自拟“五苓术芪汤”与复方丹参注射液联用治疗肝硬化腹水伴出血倾向疗效观察

Observation on curative effects of Wuling Zhuqi Decoction(五苓术芪汤) prepared by author combined with composite salvia miltiorrhiza injection on treating cirrhosis ascites complicating hemorrhage tendency

目的：观察“五芩术芪汤”合复方丹参注射液治疗肝硬化腹水伴出血倾向的疗效。方法：４８例肝硬化腹水伴出血倾向患者随机分为２组。治疗组２２例在对症、支持治疗基础上，应用“五苓术芪汤”加减及复方丹参注射液等治疗，对照组采用纯西医治疗。观察腹水、肝功能及凝血酶原时间的变化。结果：治疗１．５个月后，治疗组显效率为５９．１％，较对照组显效率（３０．８％）有非常显著性差异（Ｐ＜０．０１），且无上消化道出血等并发症发生。治疗组血清总胆红素下降、凝血酶原时间缩短及症状改善均优于对照组。结论：肝硬化腹水伴出血倾向患者应用“五苓术芪汤”及复方丹参注射液与西药联用治疗，可提高肝炎后肝硬化的治疗效果。

Objective:To observe curative effects of integrated traditional Chinese medicinc (TCM) and western medicine (WM) on cirrhosis ascites complicating hemorrhage tendency.Methods:48 cases with cirrhosis ascites complicating obviously bleeding tendency were randomly divided into two groups.The treatment group ( n =22) based on symptomatic and supportive therapy was treated with Wuling Zhuqi Decoction(五苓术芪汤) plus or minus and composite salvia miltiorrhiza injection and so on,meantime compared with control group ( n =26) which was treated with WM alone.The changes in ascites,hepatic functions,and prothrombin time (PT) were observed.Results:After one and half months therapy the markedly effective rate was 59 1% in treatment group but was 30 8% in control group and the difference was significant ( P <0 01).There were not complications of upper digestive tract hemorrhage to occure and the subside of ascites and relief of bleeding tendency were obvious.Conclusions:The treatment with Wuling Zhuqi Decoction plus or minus,composite salvia miltiorrhiza injection and WM for cirrhosis ascites existing bleeding tendency can increase the curative effects on posthepatitis cirrhosis and decrease the complications of upper digestive tract hemorrhage.