以健脾逐瘀利水法为主治疗肝硬化腹水的临床观察

Effect of Therapy of Strengthening Spleen to Eliminate Blood - stasis and Fluid Dampness for Ascites due to Liver Cirrhosis

【目的】观察以健脾逐瘀利水法为主治疗肝硬化腹水的疗效。【方法】将65例肝硬化腹水患者按区间随机分配法分为治疗组和对照组两组。治疗组予健脾消臌汤(由党参、猪苓、白术、黄芪、大腹皮、白茅根、泽兰、益母草、丹参、绵茵陈、甘遂、泽泻等组成),每日1剂,必要时结合基本西医治疗;对照组只进行基本的西医治疗。两组均治疗1个月,观察疗效,并随访半年。【结果】治疗组35例中,临床控制3例,显效12例,好转18例,无效2例;对照组30例中,临床控制1例,显效5例,好转14例,无效10例。经秩和检验,两组各级疗效差异有显著性(U=2.80,P=0.0051);经χ2检验,两组总有效率差异有显著性(χ2=8.19,P<0.01)。半年后随访,治疗组20例,总有效率为85.6％,对照组16例,总有效率为35.6％,初步说明治疗组的远期疗效优于对照组。【结论】以健脾逐瘀利水法为主治疗肝硬化腹水有较好疗效,值得临床推广应用。

[Objective] To observe the effect of therapy of strengthening spleen to eliminate blood-stasis and fluid dampness for ascites due to liver cirrhosis. [Methods] Sixty - five cases were randomly allocated to Group A and Group B by interval randomization. Group A was treated with Jianpi Xiaogu Decoction (mainly composed of Radix Codonopsis, Polyporus, Rhizoma Atractylodis Macrocephalae, Pericarpium Arecae), one dose per day, which is combined with routine western medicine when necessary and Group B was treated with routine western medicine alone. The treatment course lasted one month and then a half-a-year follow- up was carried out. [Results] After treatment, 3 was cured, 12 markedly effective, 18 effective and 2 ineffective in Group A and 1,5, 14 and 10 respectively in Group B. The differences of each ranked effect in the two group were significant (U=2.80, P=0.005) . So did the total therapeutic effect (x2 = 8.19, P < 0.01) . After a half- a - year follow - up, the total effective rate was 85.6% in Group A ( n=20) and 35.6% in Group B ( n= 16). This indicates that the long - term effect in Group A is superior to that in Group B. [Conclusion ] Therapy of strengthening spleen to eliminate blood - stasis and fluid dampness combined with routine western medicine for ascites due to liver cirrhosis exerts a certain effect and is worthy of consideration in the same situation.