补肾益肝方治疗50例肝硬化腹水患者的临床观察

Clinical Observation of BushenYigan Decoction in Treating 50Cases of Cirrhotic Ascites

目的观察补肾益肝方治疗肝硬化腹水的临床疗效。方法选取2018年1月—2020年9月期间于河南中医药大学第一附属医院就诊的肝硬化腹水患者100例,根据其就诊顺序按随机数字表法随机分为观察组和对照组,每组各50例。对照组患者给予西医基础治疗,观察组在此基础上加用补肾益肝方。治疗3个月后,观察两组患者治疗前后24 h尿量、晨起腹围、晨起体重、血清[白蛋白(Albumin,ALB)、前白蛋白(Prealbumin,PA)、胆碱酯酶(Cholinesterase,CHE)、血浆凝血酶原时间(Plasma prothrombin time,PT)]指标变化情况及临床疗效。结果治疗后观察组总有效率为92%(46/50)明显高于对照组70%(35/50),差异有统计学意义(P<0.05)。治疗后两组患者临床症状腹胀、胁痛、乏力、纳呆积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组临床症状积分均较对照组明显降低,差异有统计学意义(P<0.05)。治疗后两组患者24 h尿量较治疗前增加,两组患者晨起腹围、晨起体重较治疗前降低,差异有统计学意义(P<0.05);且观察组患者24 h尿量较对照组明显增加,晨起腹围、晨起体重较对照组明显降低,差异有统计学意义(P<0.05)。治疗后两组患者ALB、PA、CHE均较治疗前升高,PT较治疗前降低,差异有统计学意义(P<0.05);且观察组ALB、PA、CHE较对照组明显升高,差异有统计学意义(P<0.05)。治疗后两组患者彩超腹水深度、肝脏硬度值均较治疗前降低,差异有统计学意义(P<0.05);且观察组彩超腹水深度、肝脏硬度值均较对照组明显降低,差异有统计学意义(P<0.05)。结论补肾益肝方可改善肝硬化腹水患者的临床症状,增加患者24 h尿量,降低腹围及晨起体重,提高血清ALB、PA、CHE水平,降低血浆凝血酶原时间,降低彩超腹水量,改善肝脏硬度值。

Objective To observe the clinical efficacy of BushenYigan Decoction in the treatment of cirrhotic ascites.Methods One hundred patients with cirrhotic ascites treated in the First Affiliated Hospital of Henan University of Chinese Medicine from January 2018 to September 2020 were randomly divided into observation group and control group,with 50 cases in each group.The control group was given basic western treatment,while the observation group received BushenYigan Decoction on the basis of western treatment.The course of treatment was three months.The changes of clinical symptoms,24-hour urine volume,abdominal circumference and body weight in the morning,serum albumin(ALB),prealbumin(PA),cholinesterase(CHE)and plasma prothrombin time(PT)were observed before and after treatment.Results After treatment,the total effective rate of the observation group(92%,46/50)was higher than that(70%,35/50)of the control group(P<0.05).The scores of clinical symptoms such as abdominal fullness,hypochondriac pain,fatigue,and anorexia and the abdominal circumference and body weight in the morning of the two groups were decreased compared with those before treatment(P<0.05),and the decrease was more significantinthe observation group than in the control group(P<0.05).Additionally,the 24-hour urine volume and serumALB,PA and CHE levels in the two groups were increased(P<0.05),and the increase in the observation group wassuperiorto that in the control group(P<0.05).Moreover,the two groups had reduced PT,ascitic fluid depthby ultrasoundand liver hardness compared with the conditions before treatment(P<0.05),and the indexes such as ascitic fluid depth by ultrasound and liver hardness of the observation group were lower than those of the control group(P<0.05).Conclusion BushenYigan Decoction can improve the clinical symptoms of patients with cirrhotic ascites and their liver hardness,elevatethe serum ALB,PA and CHE levels andreduce plasma PT.