摘要
目的:研究中药内服联合穴位贴敷治疗脾肾阳虚水停型肝硬化腹水的临床疗效及对血清Ⅳ型胶原蛋白(Ⅳ-C)、透明质酸(HA)等指标的影响。方法:选取2020年4月—2023年4月,在青岛市黄岛区中医医院肝胆病科住院治疗的105例肝硬化腹水患者为研究对象,采用信封法,随机将研究对象分为对照组(n=52)和治疗组(n=53)。对照组给予限钠饮食、应用利尿剂等常规对症支持治疗,治疗组在对照组基础上给予中药及中医外治法穴位贴敷治疗,2组均连续治疗4周。记录2组的腹围、体重、24 h尿量、B超监测的腹水深度,检测2组的肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、白蛋白(ALB)]和肝纤维化指标[Ⅳ-C、HA、层粘连蛋白(LN)、Ⅲ型胶原(PCⅢ)]的差异,统计2组的临床疗效。结果:治疗组在腹围减小、体重减轻、腹水深度变浅、24 h尿量增多、肝功能好转、肝纤维化指标降低等方面均明显优于对照组,差异有统计学意义(P<0.05)。结论:中药内服联合中医外治——穴位贴敷疗法治疗肝硬化腹水(脾肾阳虚水停型),可增加尿量,减轻腹水程度,改善肝功能,降低肝纤维化程度。
Objective The clinical efficacy of oral administration of traditional Chinese medicine(TCM)combined with point application therapy on serumⅣ-C,HA and other indicators in the treatment of ascites due to cirrhosis with spleen-kidney Yang deficiency and water-stopping.Methods One hundred and five patients with liver cirrhosis and ascites hospitalized and treated in Qingdao Huangdao District Traditional Chinese Medicine Hospital from April 2020 to April 2023 were selected as the subjects,they were randomly divided into two groups by the envelope method.The control group(n=52)was given routine symptomatic supportive treatment such as a sodium-restricted diet and the use of diuretics.The treatment group(n=53)was given TCM and external TCM acupoint application treatment on the basis of the symptomatic group.Both groups were treated continuously for 4 weeks.The abdominal circumference,weight,urine output,and B-ultrasound ascites depth of the two groups were recorded,and the liver function[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),albumin(ALB)],and liver function of the two groups were measured.The differences in fibrosis indicators[Ⅳ-C,HA,laminin(LN),and typeⅢcollagen(PCⅢ)]were analyzed to calculate the clinical efficacy of these two groups.Results There was no statistical difference in the abdominal circumference,weight,urine output,and B-ultrasound ascites depth between the two groups before treatment(P>0.05).After treatment,the abdominal circumference of the treatment group and the control group decreased,weight decreased,urine volume increased,and B-ultrasound ascites depth became shallower.As for abdominal circumference,weight,and B-ultrasound ascites depth,the control group was lower than those of the treatment group,while the treatment group's urine volume was higher than those of the control group,with statistical differences(P<0.05).After treatment,liver function improved and liver fibrosis indicators decreased in the treatment group and the control group,while indicators of the treatment group were lower than the control group.Two groups had statistical differences(P<0.05).Conclusion Oral administration of traditional Chinese medicine combined with acupoint application can increase urine output,reduce the degree of ascites,improve liver function,and reduce the degree of liver fibrosis in the treatment of cirrhotic ascites due to spleen and kidney yang deficiency and water-stopping.
作者
张立群
王科先
ZHANG Liqun;WANG Kexian(Department of Hepatobiliary Surgery,the Traditional Chinese Medicine Hospital of Huangdao District,Qingdao,Shandong,266500,China)
出处
《中国中西医结合消化杂志》
CAS
2024年第7期594-598,共5页
Chinese Journal of Integrated Traditional and Western Medicine on Digestion
基金
山东省中医药科技项目(No:M-2022018)。
关键词
肝硬化腹水
脾肾阳虚水停型
中药内服
穴位贴敷
肝功能
肝纤维化
liver cirrhosis and ascites
spleen-kidney Yang deficiency and water-stopping type
oral administration of traditional Chinese medicine
point application therapy
liver function
liver fibrosis
作者简介
通讯作者:张立群,E-mail:1179474790@qq.com。
