腹水超滤浓缩回输联合中医辨证治疗肝硬化顽固性腹水40例临床观察

Clinical Observation on Ultrafiltration Reinfusion of Concentrated Ascites and Syndrome Differentiation for Refractory Ascites of Liver Cirrhosis: A Report of 40 Cases

目的:观察腹水超滤浓缩回输腹腔联合中医辨证治疗肝硬化顽固性腹水的临床疗效及不良反应。方法:将80例肝硬化顽固性腹水患者随机分为治疗组和对照组各40例。对照组采用附子理中汤合五苓散加减治疗;治疗组在对照组基础上采用WLFHY-500型伟力电脑腹水超滤浓缩回输系统进行腹水超滤浓缩回输腹腔治疗。结果:2组治疗后患者腹围、体质量均有明显下降(P<0.01),尿量均有明显增加(P<0.01),但治疗组较对照组在腹围、体质量下降和尿量增加方面尤为明显(P<0.05)。2组治疗前后血浆中钾、钠、氯、钙无明显变化(P>0.05),白蛋白有所升高(P<0.01),而治疗组升高较为明显(P<0.05)。总有效率、不良反应发生率治疗组分别为82.8%、7.5%,对照组分别为60.5%和5%。2组总有效率相比差异显著(P<0.05),不良反应发生率差异无显著性(P>0.05)。结论:腹水超滤浓缩回输联合中医辨证治疗是治疗肝硬化顽固性腹水。

Objective： To observe clinical efficacy and adverse reactions of ultrafiltration reinfusion of concen- trated ascites and syndrome differentiation in treating refractory ascites of liver cirrhosis. Method： All 80 patients were randomized into the treatment group and the control group. The control group took modified FuZi LiZhong Tang and Wu Ling San; besides the therapy given to the control group, the treatment group received ultrafiltration reinfusion treatment of concentrated ascites. Result： Abdominal girth and body weight of the patients were decreased significantly after treating（P〈0.01）, urinary volume was increased remarkably（P〈0.01）, but the treatment group im- proved greater than the control group in the decrease of abdominal girth and body weight, the increase of urinary volume （P〈0.05）. Potassium, sodium, chlorine and calcium in the plasma showed no changes before and after treat- ing in both groups （P〉 0.05）, albumin was improved （P〈0.01）, and the treatment group was improved more signifi- cantly （P〈0.05）. Total effective rate and the incidence of adverse reaction of the treatment group were 82.8% and 7.5%, higher than 60.5% and 5% of the control group, the difference in total effective rate was significant between both groups （P（0.05） the difference was not significant in the incidence of adverse reaction （P〉0.05）. Conclusion： Ultrafiltration reinfusion of concentrated ascites and syndrome differentiation are an emethod in treating refractory ascites of liver cirrhosis.