温肾利水法联合前列地尔治疗肝硬化并发肝肾综合征29例

The treatment by warming the kidney and promoting diuresis with Alprostadil in liver cirrhosis complicated with hepato-renal syndrome in 29 cases

目的观察温肾利水法联合前列地尔对肝硬化并发肝肾综合征患者肝、肾功能及尿量的影响。方法将57例肝硬化并发肝肾综合征患者随机分为治疗组和对照组。对照组28例,常规予限钠、支持、保肝、利尿、补充白蛋白、抗感染、应用血管扩张剂及促肝细胞生长素等对症治疗,前列地尔10μg静脉滴注。治疗组29例在对照组治疗基础上予自拟温肾利水中药汤剂口服。两组均以三周为一疗程。1疗程后观察比较两组治疗前后临床症状、腹水、肝肾功能及尿量变化。结果临床疗效比较,治疗组总有效率86.21%,对照组总有效率67.86%。两组总有效率比较差异有统计学意义(P<0.05)。结论温肾利水法联合前列地尔在肝硬化并发肝肾综合征的治疗上能更好地改善临床症状,缩短腹水消退时间,改善肝、肾功能,延缓和阻止病情的进展。

Objective To observe the influence of treatment in patients＇ urine volume,liver and renal function by warming the Kidney and promoting diuresis with Alprostadil in patients with liver cirrhosis complicated with hepato-renal syndrome.Methods 57 patients with liver cirrhosis complicated with hepato-renal syndrome were randomly divided into the treatment group and control group.The control group of 28 cases was treated with the conventional therapyby limiting the sodium intake,supporting,protecting the liver,diuresis,adding albumin,antibiotics,applying vasodilator agents and hepatocyte growth-promoting factors and symptomatic treatmentby intravenous infusion of Alprostadil 10 μg.The treatment group was treated with the conventional therapy with oral decoction by warming the kidney and promoting diuresis.The course of treatment was 3 weeks in both the groups.After 1 treatment course,observe the change of the clinical symptoms,ascites,the liver and renal function and urine volume.Results Clinical curative effect was compared.The effective rate was 86.21% in the treatment group and 67.86% the control group.The difference was statistically significant（P 〈0.05）.Conclusion The treatment by warming the kidney and promoting diuresis with Alprostadil in liver cirrhosis complicated with hepato-renal syndrome can improve the clinical symptoms,reduce the ascites subsiding time,improve the liver and renal function,delay and stop the progress of the disease.