基于中医＂固本开渠＂理论肝硬化腹水患者实施辨证施膳的效果研究

Study on the effect of applying syndrome differentiation and medicated diet in patients with liver cirrhosis ascites based on ＂Gu Ben Kai Qu＂ theory of TCM

目的 探讨基于中医＂固本开渠＂理论实施辨证施膳对肝硬化腹水患者的影响.方法 将70例肝硬化腹水患者,根据研究对象入组时间顺序随机分为观察组35例与对照组35例,对照组采用肝硬化腹水常规护理,观察组在常规护理的基础上实施基于中医＂固本开渠＂理论的辨证药膳,2组患者均采用肝硬化腹水疗效评定、肝病中医证候积分量表、尿量、腹围、体质量等进行评价.结果 观察组患者入院第7天尿量、第14天尿量、出院2周尿量、出院2周体质量、出院2周腹围分别为（1.90±0.52）L、（2.09±0.56）L、（2.02±0.35）L、（59.36±8.19）kg、（89.56±7.24）cm,对照组分别为（1.63±0.36）L、（1.79±0.40）L、（1.82±0.38）L、（63.33±8.21）kg、（93.57±7.56）cm,2组比较差异有统计学意义（F=4.108~6.484,均P〈0.05）;观察组患者的肝硬化腹水疗效分别为治愈40.0%（14/35）、好转42.9%（15/35）、未愈17.1%（6/35）,对照组分别为治愈22.9%（8/35）、好转40.0%（14/35）、未愈37.1%（13/35）,2组比较差异有统计学意义（Z=2.012,P〈0.05）.观察组患者的入院第14天、出院2周肝病中医证候积分疗效分别为显效37.1%（13/35）、有效45.7%（16/35）、无效17.2%（6/35）;显效60.0%（21/35）、有效28.6%（10/35）、无效11.4%（4/35）,对照组患者分别为显效20.0%（7/35）、有效42.9%（15/35）、无效37.1%（13/35）;显效40.0%（14/35）、有效25.7%（9/35）、无效34.3%（12/35）,2组比较差异有统计学意义（Z=2.065、2.104,均P〈0.05）.结论 基于中医＂固本开渠＂理论实施辨证施膳能有效提高肝硬化腹水患者的疗效、中医证候积分疗效、尿量,降低体质量,减小腹围,值得临床推广应用.

Objective To explore the effect of applying syndrome differentiation and medicated diet in patients with liver cirrhosis as cites based on＂Gu Ben Kai Qu＂theory of TCM. Methods Seventy patients of liver cirrhosis as cites were randomly divided into observation group （35 cases） and control group（35 cases）.The control group was cared with care routine of liver cirrhosis as cites,The observation group was based on care routine traditional nursing and implementation of dialectical medicalated meal which based on ＂Gu Ben Kai Qu＂ theory of TCM. The two groups of patients were used to assess the efficacy of liver cirrhosis as cites,urine volume,abdominal circumference,weight,TCM syndrome scale of liver disease. Results The urine volume on the 7th day, the 14th day, 2 weeks after discharge,the weight and the abdominal circumference on the 2 weeks after discharge from the patients in the observation group were respectively（1.90±0.52）L,（2.09±0.56）L,（2.02±0.35）L,（59.36±8.19）kg,（89.56±7.24）cm,while they were（1.63±0.36）L,（1.79±0.40）L,（1.82±0.38）L,（63.33±8.21）kg,（93.57±7.56）cm in the control group,the difference between the two groups was statistically significant （F=6.083, 6.484, 5.030, 4.108, 5.144,all P〈0.05）. The efficacy of liver cirrhosis as cites from the patients in the observation group were cured 40.0%（14/35）,improved 42.9%（15/35）,not cured 17.1%（6/35）,while they were cured 22.9%（8/35）,improved 40.0%（14/35）,not cured 37.1%（13/35）,the difference between the two groups was statistically significant （Z=2.012,P〈0.05）. The efficacy of TCM Syndromes on liver disease from the patients in the observation group were respectively[significant effect 37.1%（13/35）,valid 45.7% （16/35）,invalid 17.2%（6/35）],[significant effect 60.0%（21/35）,valid 28.6%（10/35）,invalid 11.4%（4/35）], while they were respectively [significant effect 20.0%（7/35）, valid 42.9%（15/35）, invalid 37.1%（13/35）], [significant effect 40.0%（14/35）,valid 25.7%（9/35）,invalid 34.3%（12/35）],the difference between the two groups was statistically significant（Z=2.065,2.104,all P〈0.05）. Conclusions Based on＂Gu Ben Kai Qu＂theory of TCM,the implementation of dialectical diet can effectively improve efficacy of liver cirrhosis as cites, reduction rate of TCM symptoms scale, urine volume,reduce the weight,shrink down the abdominal circumference,worthy of clinical application.