逐水消胀散脐敷治疗肝硬化顽固性腹水临床研究

Clinical Sudy on Zhushui Xiaozhang Powder Umbilical Application in the Treatment of Refractory Ascites Due to Cirrhosis

目的探讨逐水消胀散脐敷治疗肝硬化顽固性腹水的临床疗效。方法选取住院肝硬化顽固性腹水患者80例,经随机数字表法分为观察组40例和对照组40例。对照组患者予常规西医疗法治疗,观察组在常规治疗基础上加用逐水消胀散脐敷,2组疗程均为2周。观察2组患者治疗前后体质量、腹围、24 h尿量、丙氨酸氨基转氨酶(ALT)、肝功能Child-Pugh评分及肾小球滤过率(GFR)的变化,并观察不良反应,评价患者的用药安全性。结果肝硬化RA患者逐水消胀散脐敷治疗前后,体质量、腹围及24 h尿量差异有统计学意义(P<0.05,P<0.01),而且24 h尿量明显多于对照组(P<0.01);2组患者治疗后肝功能Child-Pugh评分均有明显改善(P<0.01),且逐水消胀散脐敷治疗组的改善情况明显优于对照组(P<0.05),但肾小球滤过率(GFR)变化则不明显(P>0.05)。结论逐水消胀散脐敷治疗肝硬化顽固性腹水,可通过增加24 h尿量及改善肝功能Child-Pugh评分而发挥疗效,并通过降低患者体质量及腹围而缓解患者临床主要不适症状,增加治疗依从性。

Objective To investigate the clinical effect of Zhushui Xiaozhang powder umbilical application in the treatment of refractory ascites(RA)due to cirrhosis.Methods 80 patients with RA due to liver cirrhosis hospitalized were randomly divided into observation group(40 cases)and control group(40 cases).The control group was treated with conventional western medicine,and the observation group was treated with Zhushui Xiaozhang powder umbilical application based on the conventional treatment.The course of treatment in both groups was 2 weeks.The changes of body weight,abdominal circumference,24-hour urine volume,alanine aminotransferase(ALT),Child Pugh score of liver function and glomerular filtration rate(GFR)were observed before and after treatment in the two groups,and the adverse reactions were observed to evaluate the safety of medication.Results The body weight,abdominal circumference and 24-hour urine volume of cirrhotic RA patients before and after treatment with Zhushui Xiaozhang powder were significantly different(P<0.05,P<0.01),and the24-hour urine volume was significantly higher than that of the control group(P<0.01).The Child Pugh score of liver function in the two groups after treatment was significantly improved(P<0.01),and the improvement of the observation group was significantly better than that of the control group(P<0.05),but the GFR did not change significantly(P>0.05).Conclusion Zhushui Xiaozhang powder umbilical application in the treatment of RA due to liver cirrhosis can increase 24-hour urine volume and improve child Pugh score of liver function,relieve the main clinical symptoms of patients by reducing body weight and abdominal circumference,and increase treatment compliance.