摘要
目的:观察利水消臌膏外敷联合肝病治疗仪治疗乙肝后肝硬化顽固性腹水的疗效。方法:按随机数字表法把120例乙肝后肝硬化顽固性腹水患者分为对照组、观察组,每组各60例。对照组予以DSG-Ⅲ肝病治疗仪和常规西医基础治疗,观察组在对照组基础上加利水消臌膏肝区及腹部外敷。连续治疗4周,对比分析两组患者治疗前后体质量、腹围、24 h尿量、临床症状量化积分、肝功能、内皮素-1(ET-1)、一氧化氮(NO)、γ干扰素(IFN-γ)的变化情况,并用彩色多普勒超声评估治疗前后门静脉血流动力学变化情况。结果:两组患者经治疗4周后,观察组治疗总有效率为87.72%(50/57),高于对照组的67.9%(38/56),差异具有统计学意义(χ^(2)=6.411,P<0.05)。两组患者腹围、体质量和24 h尿量均优于本组治疗前(P<0.05);治疗后,上述指标观察组优于对照组(P<0.05)。中医临床症状积分方面,对照组食欲、乏力、睡眠、身目发黄与治疗前差异无统计学意义,其余各项指标两组患者均优于本组治疗前(P<0.05);治疗后,观察组在腹胀、胁痛、食欲、乏力、下肢水肿等症状改善方面均优于对照组(P<0.05),但在改善睡眠和身目发黄方面两组之间差异无统计学意义。实验室检查方面,两组患者总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、白蛋白/球蛋白(AGR)、ET-1、NO、IFN-γ各指标组内比较标均优于本组治疗前(P<0.05);治疗后,两组患者TBIL差异无统计学意义,其余指标观察组均优于对照组(P<0.05)。在门静脉血流动力学方面,与本组治疗前比较,两组患者门静脉主干内径(D_(pv))、最大血流速度(V_(max)),门脉血流量(Q)均有明显改善(P<0.05);治疗后,观察组D_(pv)、V_(max)、Q改善程度优于对照组(P<0.05)。结论:利水消臌膏外敷联合肝病治疗仪可显著提高乙肝后肝硬化顽固性腹水的有效率,作用机制可能与减少NO、ET-1水
Objective:To observe the curative effect of Lishui Xiaogu plaster combined with liver disease therapeutic apparatus on the treatment of refractory ascites due to hepatitis B cirrhosis.Method:A total of 120 cases of refractory ascites due to hepatitis B cirrhosis were randomly divided into a control group and an observation group,with 60 cases in each group.The control group was treated with conventional western medicine and DSG-Ⅲliver disease therapeutic apparatus,and the observation group was externally applied with Lishui Xiaogu plaster in the liver area and abdomen based on the control group.After 4 weeks of continuous treatment,the weight,abdominal circumference,24-hour urine volume,the quantitative score of clinical symptoms,liver function,serum endothelin-1(ET-1),nitric oxide(NO),and interferon-γ(IFN-γ)before and after treatment were observed in the patients of two groups.Result:After 4 weeks of treatment,the total effective rate of the observation group was 87.72%(50/57),higher than 67.9%(38/56)in the control group(P<0.05)(χ^(2)=6.411,P<0.05).The changes in abdominal circumference,body weight,and 24-hour urine volume in the two groups were better than those before treatment(P<0.05).In terms of traditional Chinese medicine(TCM)clinical symptom scores,there was no significant difference in the symptoms of appetite,fatigue,sleep,and yellowing of the body and eyes in the control group before and after treatment,and other indexes in the two groups were better than those before treatment(P<0.05).The observation group was better than the control group in improving symptoms such as abdominal distension,hypochondriac pain,appetite,fatigue,and lower limb edema(P<0.05),but there was no significant difference between the two groups in improving sleep and yellowing of the body and eyes.In the experiment,the total bilirubin(TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST),albumin/globulin ratio(AGR),ET-1,NO,and IFN-γin the two groups were all better than those before treatment(P<0.05).Except tha
作者
王岗
朱琦
陈新
岳仁宋
车德亚
WANG Gang;ZHU Qi;CHEN Xin;YUE Rensong;CHE Deya(Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610075,China;Zigong First People's Hospital,Zigong 643000,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2022年第22期123-130,共8页
Chinese Journal of Experimental Traditional Medical Formulae
基金
四川省中医药管理局科学技术研究专项(2018QN073)。
关键词
乙肝后肝硬化
顽固性腹水
利水消臌膏
中药外敷
肝病治疗仪
hepatitis B cirrhosis
refractory ascites
Lishui Xiaogu plaster
Chinese medicine external application
liver disease therapeutic apparatus
