补肾健脾活血法对肝硬化失代偿期患者腹水再发的影响

The Effect of Tonifying Kidney,Invigorating Spleen and Promoting Blood Circulation on the Recurrence of Ascites in Patients with Decompensated Cirrhosis

目的观察补肾健脾活血法对肝硬化失代偿期患者腹水再发的预防效果。方法 60例肝硬化失代偿期患者均是经内科治疗腹水消退后的门诊患者,随机分为补肾健脾活血组、补肾活血组、健脾活血组、对照组各15例,四组均要求低盐高蛋白清淡饮食,常规保肝治疗,补肾健脾活血组加用加味养肝五物汤合四君子汤,健脾活血组加用加味四君子汤口服,补肾活血组予以加味养肝五物汤,对照组常规保肝治疗,采用治疗后组间对照研究,比较四组腹水再发情况。疗程4 W。结果补肾健脾活血组腹水再发3例,有效率80%;健脾活血组腹水再发6例,有效率60%;补肾活血组腹水再发5例,有效率66.67%,对照组腹水再发8例,有效率46.67%。结论补肾健脾活血法对肝硬化失代偿期患者腹水再发有较好地预防作用。

Objective： To observe the effect of tonifying kidney, invigorating spleen and promoting blood circulation on the control of aseites recurrence in patients with deeompensated cirrhosis. Methods： 60 patients with deeompensated cirrhosis whose aseites faded away after the treatment in the Department of Internal Medicine were randomized into Bushen Jianpi Huoxue group （tonifying kidney, invigorating spleen and promoting blood circulation） , Bushen Huoxue group （tonifying kidney and promoting blood circulation）, Jianpi Huoxue group （ invigorating spleen and promoting blood circulation）, and control group. There were 15 patients in each group. All the patients in the four groups were required to have a light diet with low salt and high protein. They all received conventional liver protecting therapy. Bushen Jianpi Huoxue group were added with modified Yang Gan Wu Wu decoction and Si Jun Zi decoction, Jianpi Huoxue group were added with modified Si Jun Zi decoction, Bushen Huoxue group were given modified Yang Gan Wu Wu decoction, and the control group only received conventional liver protecting therapy. The recurrence aseites was compared between groups. The treatment course was 4 weeks. Results： There were3 recurrence cases in Bushen Jianpi Huoxue group with an effective rate of 80 % ; 6 recurrence cases in Jianpi Huoxue group with an effective rate of 60 % ; 5 recurrence cases in Bushen Huoxue group with an effective rate of 66. 67 % ; 8 recurrence cases in the control group with an effective rate of 46.67 %. Conclusion： Tonifying kidney, invigorating spleen and promoting blood circulation can effectively control the recurrence of ascites in patients with decompensated cirrhosis.