行气健脾法联合西药治疗肝硬化合并糖代谢异常伴自发性腹膜炎的疗效观察

Curative effect observation of invigorating Qi and invigorating spleen method combined with western medicine in the treatment of abnormal glucose metabolism in liver cirrhosis complicated with spontaneous bacterial peritonitis

目的观察行气健脾法联合西药治疗肝硬化合并糖代谢异常伴自发性腹膜炎的临床疗效。方法将60例肝硬化合并糖代谢异常伴自发性腹膜炎患者随机分为观察组和对照组,每组30例。观察组采用行气健脾法,方选七味白术散加减,联合头孢三代抗生素抗感染、胰岛素及对症支持的西药治疗,对照组单用西药治疗,疗程均3周。观察2组治疗前后腹水白细胞(WBC)、多形核白细胞(PMN)、细菌培养、李凡他试验数据变化情况,比较2组临床治疗效果。结果治疗后,观察组总有效率为82.23%,高于对照组的67.56%(P<0.05)。2组WBC、PMN、细菌培养阳性例数、李凡他试验阳性例数较治疗前均改善(P<0.05);且观察组改善情况优于对照组(P<0.05)。结论行气健脾法联合西药治疗肝硬化合并糖代谢异常伴自发性腹膜炎疗效优于单用西药。

Objective To explore clinical curative effect of using method of invigorating spleen and Qi combined with western medicine in the treatment of liver cirrhosis combined with abnormal glucose metabolism and spontaneous bacterial peri- tonitis. Methods 60 patients of liver cirrhosis combined with abnormal glucose metabolism and spontaneous bacterial peritoni- tis were randomly divided into treatment group and control group, each of 30 cases. Patients in treatment group were treated with Qiwei Baizhu powder invigorating spleen and Qi, combined with western medicine treatment about the third-generation cephalo- sporins, insulin, symptomatic support drug,while the control group only treated with western medicine. The course of treatment was 3 weeks. The changes of ascites white blood cell （ WBC）, polymorphonuclear leukocyte （ PMN）, bacterial culture and Li Fanta test were observed before and after treatment in 2 groups. Then compare the clinical treatment effect of the 2 groups. Re- suits After treatment, the total effective rate of the treatment group was 82.23%, which was higher than 67.56% of the con- trol group （P 〈 O. 05 ）. In both group, the WBC and PMN, positive cases of bacterial culture, positive cases of Li Fanta test were improved compared with before treatment （ P 〈 0.05 ）. The treatment group was better than the control group （ P 〈 0. 05）. Conclusion Method of invigorating spleen and Qi combined with western medicine in the treatment of liver cirrhosis combined with abnormal glucose metabolism and spontaneous bacterial peritonitis is superior to western medicine alone.