特利加压素联合中药敷脐在肝硬化腹水患者中的应用

Application of terlipressin combined with traditional Chinese medicine on umbilicus in patients with liver cirrhosis and ascites

目的 探讨特利加压素联合中药敷脐对肝硬化腹水患者腹围、中医证候积分及血清炎症因子水平的影响。方法 采用回顾性研究方法,选取2019年10月至2021年10月浙江大学医学院附属第二医院临平院区收治的肝硬化腹水患者96例为研究对象,根据治疗方法不同将其分为常规组和研究组,每组各48例。常规组患者采用特利加压素治疗,研究组患者采用特利加压素联合中药敷脐治疗。两组患者均连续用药14d,对比两组患者治疗前后的腹围、体质量、24h尿量、中医证候积分(腹大胀满、胸肋刺痛、脘闷纳呆、下肢水肿)、血清炎症因子[白细胞介素–6(interleukin–6,IL–6)、肿瘤坏死因子–α(tumor necrosis factor–α,TNF–α)、γ干扰素(interferon–γ,IFN–γ)]水平。结果 治疗14d后,研究组患者的腹围缩小及体质量下降明显多于常规组,24h尿量明显多于常规组,差异均有统计学意义(P<0.05);研究组患者的腹大胀满、胸肋刺痛、脘闷纳呆、下肢水肿等中医症状积分均明显低于常规组,差异均有统计学意义(P<0.05);研究组患者的IL–6、TNF–α、IFN–γ水平均明显低于常规组,差异均有统计学意义(t=13.432、10.299、8.433,均P<0.05)。结论 对肝硬化腹水患者应用特利加压素联合中药敷脐治疗,可有效降低血清炎症因子水平,减轻机体炎性反应,有效减少腹水量,促使患者尽快康复。

Objective To explore the effects of teropressin combined with traditional Chinese medicine(TCM) on abdominal circumference, TCM syndrome score and serum inflammatory factors in patients with liver cirrhosis ascites. Methods A total of 96 cirrhotic ascites patients admitted to Linping District, the Second Affiliated Hospital,Zhejiang University School of Medicine from October 2019 to October 2021 were conduct a retrospective study as the study subjects. The patients were divided into conventional group and study group according to the treatment method, 48 cases in each group. The patients of conventional group were treated with teripressin, and the patients of study group were treated with teripressin combined with TCM on umbilicus. Both groups of patients were treated with continuous medication for 14 days. Abdominal circumference, body weight, 24 hours urine volume, TCM syndrome score(abdominal distension, thorax and rib pain, epigastric depression, lower limb edema) and serum inflammatory factor [interleukin–6(IL–6), tumor necrosis factor–α(TNF–α), interferon–γ(IFN–γ)] levels in both groups were compared before and after treatment. Results After 14 days of treatment, abdominal circumference and body weight of the study group were significantly decreased, 24 hours urine volume was significantly higher than that of the conventional group,the differences were statistically significant(P<0.05). The scores of TCM symptoms in the study group were significantly lower than those in the conventional group, the differences were statistically significant(P<0.05). The levels of IL–6, TNF–α and IFN–γ in the study group were significantly lower than those in the conventional group, the difference between the two groups were statistically significant(t=13.432, 10.299, 8.433;all P<0.05).Conclusion Telopressin combined with traditional Chinese medicine for the treatment of liver cirrhosis ascites can effectively reduce the level of serum inflammatory factors, reduce the body’s inflammatory response, effectively reduce the volume of ascites, and promote the patients to recovery as soon as possible.