消胀贴敷脐联合常规西药治疗乙型病毒性肝炎肝硬化腹水的临床效果

Clinical effect of Xiaozhang plaster apply umbilicus combined with conventional western medicine in the treatment of ascites due to hepatitis B cirrhosis

目的探讨消胀贴敷脐联合常规西药治疗乙型病毒性肝炎肝硬化腹水的临床效果。方法选取2018年9月至2020年9月于本院消化内科住院治疗的50例乙型病毒性肝炎肝硬化腹水患者,采用抽签法将其分为对照组和研究组,各25例。对照组给予常规西药治疗,研究组在对照组基础上给予消胀贴敷脐。比较两组的临床疗效、24 h尿量、腹水深度、Child-Pugh评分、中医症状评分、LPS、IMA水平及脾、门静脉血流动力学指标。结果研究组的治疗总有效率为96.0%,高于对照组的76.0%,差异具有统计学意义(P<0.05)。治疗后,研究组的24 h尿量多于对照组,腹水深度、Child-Pugh评分低于对照组,差异具有统计学意义(P<0.05)。治疗后,研究组的腹胀、黄疸、纳差、肋痛、乏力评分低于对照组,差异具有统计学意义(P<0.05)。治疗后,研究组的LPS、IMA水平低于对照组,差异具有统计学意义(P<0.05)。治疗后,研究组的DSV、DPV小于对照组,VSV、VPV高于对照组,差异具有统计学意义(P<0.05)。结论消胀贴敷脐联合常规西药治疗乙型病毒性肝炎肝硬化的效果较好,可减少腹水,缓解患者中医症状,降低LPS、IMA水平,改善脾、门静脉血流动力学指标,值得临床应用和推广。

Objective To investigate the clinical effect of of Xiaozhang plaster apply umbilicus combined with conventional western medicine in the treatment of ascites due to hepatitis B cirrhosis.Methods Fifty patients with ascites due to hepatitis B cirrhosis hospitalized in the gastroenterology department of our hospital from September 2018 to September2020 were selected and divided into control group and study group by drawing lots method,with 25 cases in each group.The control group was given conventional western medicine treatment,and the study group was given Xiaozhang plaster apply umbilicus on the basis of the control group.The clinical efficacy,24 h urine volume,ascites depth,Child-Pugh score,TCM symptom score,LPS,IMA levels and hemodynamic indexes of spleen and portal vein were compared between the two groups.Results The total effective rate of treatment in the study group was 96.0%,which was higher than 76.0% in the control group,and the difference was statistically significant(P<0.05).After treatment,the 24 h urine volume of the study group was more than that of the control group,and the ascites depth and Child-Pugh score were lower than those of the control group,and the differences were statistically significant(P <0.05).After treatment,the scores of abdominal distension,jaundice,anorexia,costalgia and fatigue in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of LPS and IMA in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,DSV and DPV in the study group were smaller than those in the control group,and VSV and VPV were higher than those in the control group,and the differences were statistically significant(P <0.05).Conclusion The Xiaozhang plaster apply umbilicus combined with conventional western medicine in the treatment of ascites due to hepatitis B cirrhosis has a better effect,it can reduce ascites,alleviate TCM symptom,reduce the levels of LPS and IMA,and improve the hemodynamic indexes of spleen and portal vein,which is worthy of clinical application and promotion.