摘要
目的:探究健脾利水汤联合螺内酯治疗脾肾阳虚型肝硬化腹水的效果。方法:选取2021年4月—2024年3月惠州市中医医院收治的100例脾肾阳虚型肝硬化腹水患者作为研究对象,按随机数表法分为对照组(n=50)和观察组(n=50)。两组均给予控制水和钠盐摄入、治疗原发病、纠正低蛋白血症等常规西医治疗,对照组采用螺内酯治疗,观察组采用健脾利水汤联合螺内酯治疗。比较两组临床疗效、中医症候积分、临床指标、肝功能指标[天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、白蛋白(ALB)、谷丙转氨酶(ALT)]及凝血指标[凝血酶原时间(PT)]。结果:观察组总有效率高于对照组,差异有统计学意义(P<0.05);与治疗前相比,两组治疗后小便少、腰膝酸软、腹部胀满、恶心呕吐、腹胀、浮肿评分均降低,且观察组低于对照组,差异有统计学意义(P<0.05);与治疗前相比,两组治疗后腹围减小,且观察组小于对照组,两组治疗后24 h尿量增加,且观察组多于对照组,差异有统计学意义(P<0.05);与治疗前相比,两组治疗后AST、ALT、TBIL降低,且观察组低于对照组,而两组治疗后ALB升高,且观察组高于对照组,差异有统计学意义(P<0.05);与治疗前相比,两组治疗后PT缩短,且观察组短于对照组,差异有统计学意义(P<0.05)。结论:相较于螺内酯,健脾利水汤联合螺内酯治疗脾肾阳虚型肝硬化腹水患者效果显著,可缓解症状和体征,改善肝功能及凝血功能。
Objective:To observe the effect of Jianpi Lishui Decoction combined with Spironolactone in the treatment of liver cirrhosis ascites of spleen-kidney Yang deficiency type.Method:A total of 100 patients with liver cirrhosis ascites of spleen-kidney Yang deficiency type who admitted to Huizhou Hospital of Traditional Chinese Medicine from April 2021 to March 2024 were selected as the research objects and divided into the control group(n=50)and the observation group(n=50)according to the random number table method.Both groups were given conventional western medicine treatment such as controlling water and sodium salt intake,treating primary disease,and correcting hypoproteinemia,the control group was treated with Spironolactone,and the observation group was treated with Jianpi Lishui Decoction combined with Spironolactone.The clinical efficacy,traditional Chinese medicine symptom score,clinical indicators,liver function indicators[aspartate aminotransferase(AST),total bilirubin(TBIL),albumin(ALB),alanine aminotransferase(ALT)]and coagulation indicators[prothrombin time(PT)]were compared between two groups.Result:The total effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05);compared with before treatment,the scores of less urine,soreness and weakness of waist and knees,abdominal distension,nausea and vomiting,abdominal distension and edema in two groups were decreased after treatment,and those in the observation group were lower than the control group,the differences were statistically significant(P<0.05);compared with before treatment,the abdominal circumference of two groups were decreased after treatment,and that in the observation group was smaller than that in the control group,the 24 h urine volume of two groups were increased after treatment,and that in the observation group was more than that in the control group,the differences were statistically significant(P<0.05);compared with before treatment,the AST,ALT and TBIL of two groups were decreased after treatment,and those in the observation group were lower than those in the control group,while the ALB of two groups were increased after treatment,and that in the observation group was higher than that in the control group,the differences were statistically significant(P<0.05);compared with before treatment,the PT of two groups were shortened after treatment,and that in the observation group was shorter than that in the control group,the differences were statistically significant(P<0.05).Conclusion:Compared with Spironolactone,Jianpi Lishui Decoction combined with Spironolactone has a significant effect in the treatment of liver cirrhosis ascites of spleen-kidney Yang deficiency type,which can relieve symptoms and signs,improve liver function and coagulation function.
作者
谭文涛
凌家生
张慧勤
梁瑞华
TAN Wentao;LING Jiasheng;ZHANG Huiqin;LIANG Ruihua(Huizhou Hospital of Traditional Chinese Medicine,Huizhou 516001,China;不详)
出处
《中外医学研究》
2025年第7期115-119,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
健脾利水汤
螺内酯
肝硬化腹水
中医症候积分
Jianpi Lishui Decoction
Spironolactone
Liver cirrhosis ascites
Traditional Chinese medicine symptom score
