肝硬化腹水的中医药诊疗进展

A review on treating cirrhotic ascites in TCM

肝硬化腹水是肝硬化失代偿期的常见并发症,属中医学"臌胀"范畴,为"风、痨、鼓、膈"四大顽症之一。其形成常由多种原因共同作用,如门脉压力增高、低蛋白血症、水钠潴留、周围血管扩张等。大量腹水可造成患者腹胀及饮食、呼吸与行动困难,并可增加腹腔感染、肾功能衰竭等并发症的风险,反复发作腹水严重影响患者的生活质量及预后,目前西医对该病仍未取得理想的治疗效果且复发率高,而中医从整体观念辨证论治和特色治疗出发,取得了一定的疗效。中医药治疗对于改善失代偿期肝硬化患者的生活质量极其重要。本文就肝硬化腹水的中医病因病机、诊疗现状及进展进行综述。

Ascites of liver cirrhosis is a common complication of decompensation of cirrhosis. It belongs to the category of Guzhang（ 臌胀） in traditional Chinese medicine. It is one of the four major obstinate diseases of Feng（ 风）, Lao（ 痨）, Gu（ 鼓） and Ge（ 膈）. Its formation is often caused by a variety of factors, such as increased portal pressure, hypoproteinemia, water and sodium retention, peripheral vasodilation, and so on. A large amount of ascites may cause abdominal distension, difficulty in eating, breathing and moving, and increase the risk of complications such as abdominal infection, renal failure, etc. Repeated episodes of ascites can seriously affect the quality of life and prognosis of patients. At present, Western medicine has not achieved ideal therapeutic effect and it has high recurrence rate, but TCM has achieved certain curative effect from the whole concept of syndrome differentiation and characteristic treatment. Traditional Chinese medicine is very important to improve the quality of life of patients with decompensated cirrhosis. This article reviews the etiology, pathogenesis, diagnosis and treatment of ascites in cirrhotic patients.