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Received:October 08, 2019 Published Online:February 20, 2020
Received:October 08, 2019 Published Online:February 20, 2020
中文摘要: 目的 观察马兰草脐灸联合健脾活血祛湿方治疗肝硬化腹水的方法和临床疗效。方法 选择2017年6月至2018年12月收治的60例肝硬化腹水患者,随机分为对照组和治疗组,各30例。对照组采用西医常规治疗,治疗组在对照组治疗的基础上加用马兰草脐灸联合中药健脾活血祛湿方治疗。两组均观察治疗30 d(1个疗程)。比较两组治疗前后综合疗效、中医证候疗效、肝功能指标［丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、血清白蛋白(ALB)、总胆红素(TBIL)］、腹水深度、体重等一般情况,及血清钾离子(K+)、钠离子(Na+)、血尿素氮(BUN)、血肌酐(Scr)、血氨(NH3)等指标。结果治疗组综合疗效总有效率略高于对照组(90.00% vs 73.33%,P>0.05),中医证候总有效率略高于对照组(96.67% vs 76.67%,P>0.05),但差异均无统计学意义。治疗后,两组患者中医症候积分和腹水深度均较治疗前降低,且治疗组低于对照组(P<0.05，P<0.01)。两组患者体重、腹围较治疗前减少,24 h尿量较治疗前增加,且治疗组优于对照组(P<0.05)。两组患者ALT、AST、TBIL均较治疗前下降,且治疗组低于对照组;ALB均较治疗前升高,且治疗组高于对照组(P<0.05)。治疗前后两组患者K+、Na+、BUN、Scr、NH3水平比较差异均无统计学意义(P>0.05)。结论在西医常规治疗基础上采用马兰草脐灸联合健脾活血祛湿方治疗肝硬化腹水的临床疗效肯定,安全性高。
Abstract:Objective To observe the clinical efficacy of Kalimeris indica(L.) Sch.Bip.umbilical moxibustion combined with Jianpi Huoxue Qushi decoction in the treatment of cirrhotic ascites.Methods Sixty patients with cirrhotic ascites treated from June 2017 to December 2018 were randomly divided into control group and treatment group(n=30,each).The conventional western medicine was given in control group,while Kalimeris indica(L.) Sch.Bip.umbilical moxibustion combined with Jianpi Huoxue Qushi decoction was added in treatment group on the basis of the regimen of control group.After treatment for 30 days in two groups,the comprehensive curative effect,TCM syndrome curative effect,liver function indexes (ALT,AST,ALB,TBIL),depth of ascites,body weight,levels of potassium ion (K+),serum sodium (Na+),blood urea nitrogen(BUN),serum creatinine (Scr),blood ammonia (NH3) were observed and compared before and after treatment between two groups.Results There were no statistical differences in the comprehensive curative effective rate(90.00% vs 73.33%,P>0.05) and the total effective rate of TCM syndrome(96.67% vs 76.67%,P>0.05).After treatment,TCM symptom score,depth of ascites,body weight,abdominal circumference were significantly lower than those before treatment in two groups and were statistically lower in treatment group than those in control group (P<0.05,P<0.01);the urine volume in 24 hours was significantly higher than that before treatment in both groups and increased statistically in treatment group compared with control group(P<0.05);the levels of ALT,AST and TBIL decreased and ALB level increased in both groups,and the treatment group was superior to the control group(P<0.05).There were no significant differences in levels of K+,Na+,BUN,Scr,NH3 before and after treatment between two groups(P>0.05).Conclusion On the basis of conventional western medicine treatment,Kalimeris indica(L.) Sch.Bip.umbilical moxibustion combined with Jianpi Huoxue Qushi decoction has a positive clinical effect and high safety in the treatment of cirrhotic ascites.
keywords: Cirrhotic ascites Kalimeris indica(L.) Sch .Bip.[BFQ] Umbilical moxibustion Jianpi Huoxue Qushi decoction Depth of ascites Traditional Chinese Medicine syndrome
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基金项目:国家自然科学基金(81860887,81560771);贵州省教育厅青年科技人才成长项目(黔教和KY［2016］184);贵州省科技厅合作计划项目(黔科合LH字［2015］7293号);贵州省中医药、民族医药科学技术专项课题项目(QZYY2018013)；贵州省2017年度高层次创新型人才项目（黔人领发〔2018〕5号）；贵阳市科技计划项目(筑科合同［20174］20号)
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