一贯煎合猪苓汤联合西药治疗肝肾阴虚型肝硬化腹水临床观察

Clinical Observation of Yiguan Jian and Zhuling Tang Combined with Western Medicine for Cirrhosis Ascites with the Syndrome of Liver and Kidney Yin Deficiency

目的:观察一贯煎合猪苓汤联合西药治疗肝肾阴虚型肝硬化腹水患者的临床疗效。方法:将76例肝肾阴虚型肝硬化腹水患者随机分为对照组与治疗组,对照组给予肝硬化腹水西医常规治疗,治疗组在对照组治疗基础上加服一贯煎合猪苓汤,2组均治疗2周,观察2组患者腹围、体质量、尿量、中医证候积分及肝功能指标的变化。结果:治疗组总有效率为91.43%,对照组总有效率为77.14%。2组疗效经秩和检验,差异有统计学意义(P<0.05)。治疗后,2组中医证候积分均较治疗前下降,差异均有统计学意义(P<0.05,P<0.01),治疗组中医证候积分低于对照组,差异有统计学意义(P<0.05)。2组腹围、体质量均较治疗前下降,差异均有统计学意义(P<0.01,P<0.05);治疗组尿量较治疗前增加,差异有统计学意义(P<0.05),而对照组治疗前后尿量比较,差异无统计学意义(P>0.05);治疗组腹围、体质量、尿量的改善均优于对照组(P<0.05)。2组总胆红素(TBil)、直接胆红素(DBil)、谷丙转氨酶(ALT)、谷草转氨酶(AST)与治疗前比较,差异均有统计学意义(P<0.01,P<0.05);在改善白蛋白(Alb)方面,对照组与治疗前比较无统计学差异(P>0.05),治疗组Alb较治疗前升高(P<0.05);2组各指标比较,差异均有统计学意义(P<0.05)。结论:应用一贯煎合猪苓汤联合西药治疗肝肾阴虚型肝硬化腹水患者不仅可以提高疗效,还可有效改善患者的临床症状与肝功能指标等。

Objective： To observe the clinical effect of Yiguan jian and Zhuling tang combined with western medicine in treating patients with cirrhosis ascites of the syndrome of liver and kidney yin deficiency. Methods： Divided 76 cases of patients with cirrhosis ascites of liver and kidney yin deficiency into the control group and the treatment group randomly.Both groups were given the treatment of routine western medicine for cirrhosis ascites. The treatment group was additionally treated with Yiguan jian and Zhuling tang. The two groups were both treated for two weeks. Observed changes of abdominal circumference, body mass, urine volume, scores of Chinese medicine syndrome and liver function indexes in two groups.Results： The total effective rate was 91.43% in the treatment group and 77.14% in the control group, the significant difference being found by rank sum test（P 〈 0.05）. After treatment, scores of Chinese medicine syndrome in two groups were reduced（P 〈 0.05, P 〈 0.01）, and scores of Chinese medicine syndrome in the treatment group were lower than those in the control group（P 〈 0.05）. Abdominal circumference and body mass in both groups were declined after treatment（P 〈 0.01, P 〈 0.05）. After treatment, urine volume in the treatment group was increased（P 〈 0.05）, but no significant difference was found in the comparison of urine volume before and after treatment in the control group（P 〉 0.05）.Improvements of abdominal circumference, body mass and urine volume in the treatment group were superior to those in the control group（P 〈 0.05）. After treatment, compared total bilirubin（TBil）, direct bilirubin（DBil）, alanine aminotransferase（ALT） and aspartate aminotransferase（AST） in both groups with those before treatment,differences was significant（P 〈 0.01,P 〈 0.05）. In terms of Albumin（Alb）, there was no significant difference in the comparison（P 〉 0.05）. Alb in the treatment group was increased, comparing with that before treatment（P 〈 0.05）. Compared indexes in both groups before and after treatment,differences were significant（P 〈 0.05）. Conclusion：The therapy of Yiguan jian and Zhuling tang combined with western medicine for cirrhosis ascites of liver and kidney yin deficiency not only can enhance the curative effect, but also can effectively improve clinical symptoms and liver function indexes.