中药内服外敷治疗肝硬化难治性腹水的疗效观察

摘要

目的：探讨病证结合中药内服与消胀贴膏脐部外敷对肝硬化难治性腹水的治疗作用。方法：选择2011年3月至2014年2月我科肝硬化难治性腹水患者80例，随机分为对照组与观察组，对照组以常规西药治疗，观察组在其基础上，采用病证结合中药复方内服，并脐敷中药消胀贴膏。比较治疗前后患者体重、腹围、24小时尿量、主要症状（腹胀、纳食、排气、排便）及血清肝肾功能、电解质。结果：脱落1例，完成79例。2组患者基线资料一致。对体重、腹围、尿量以及主要症状，2组治疗后均明显改善，而治疗前后体重、腹围、尿量、腹胀、纳食及排气前后差值的组间比较，观察组均优于对照组，观察组显效率明显高于对照组。2组间治疗前后肝肾功能及电解质差值无统计学意义。结论：对于肝硬化难治性腹水患者，病证结合中药内服与消胀贴膏脐部外敷可提高常规西药治疗的临床疗效。%Objective:To investigate the efficacy of oral traditional Chinese herbal of combination disease and syndrome and um-bilical compress with Xiaozhang Tie cataplasm in treating refractory ascites induced by liver cirrhosis.Methods:Eighty patients with cirrhosis and refractory ascites were randomly divided into two groups of equal size.The patients in control group were treated with primary therapy,while the test group took an oral traditional Chinese herbal of combination disease and syndrome and umbili-cal compress with Xiaozhang Tie cataplasm additionally.Efficacy was evaluated according to the criterion including ascites volume, body weight,abdominal circumference,urine 24-hour volume and major syndromes including abdominal distention,appetite,fla-tus and defecation.Results:Seventy-nine patients completed the study,1 were withdrawn.The two groups were comparable on baseline.Both groups showed decreased body weight and abdominal circumference,increased urine volume and improved symp-toms after treatment.However,the differences between pre-treatment and post-treatment in body weight,abdominal circumfer-ence,urine volume,abdominal distention,appetite and flatus were noticeably higher in the test group (n=39)than those in the control group (n=40).The effective rate of grade I and grade II was 52.5%for the test group and 25.0%for the control one (P<0.05 ).Conclusion:Traditional Chinese herbal of combination disease and syndrome and umbilical compress with Xiaozhang Tie cataplasm shows a remarkable adjuvant efficacy on refractory ascites induced by cirrhosis.