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目的观察自拟化瘀利水、益气疏肝方联合常规西药治疗乙肝肝硬化腹水的临床效果。方法选取2013年1月~2015年6月我院收治的110例乙肝肝硬化腹水患者,随机分为联合治疗组和常规西药治疗组(n=55),联合治疗组患者在常规西药治疗基础上加用自拟化瘀利水、益气疏肝方煎水口服。疗程均为1个月,随访6个月。检测丙氨酸氨基转移酶(ALT)、天门冬酸氨基转移酶(AST)、白蛋白(Alb)及总胆红素(TBil)水平;观察患者腹胀、食欲不振、乏力、少尿、下肢水肿和黄疸等症状和体征,以及腹围值和24 h尿量变化,治疗后评价临床疗效。结果与治疗前相比,治疗后两组患者出现腹胀、食欲不振、乏力、少尿、下肢水肿和黄疸等症状和体征的病例数均明显减少;患者腹围值也减小,同时24 h尿量增多;ALT、AST、Alb和TBil指标明显改善,两组间比较,上述症状和体征及实验室指标,联合治疗组均显著优于常规西药治疗组(P<0.05)。治疗总有效率组间比较,联合治疗组高于常规西药治疗组(89.09%对74.55%,P<0.05);随访6个月的复发率,联合治疗组低于西药组(10.91%对23.64%,P<0.05)。结论自拟化瘀利水、益气疏肝方联合常规西药治疗,可有效改善乙肝肝硬化腹水患者主要症状和体征,以及肝功能等实验室指标,且总有效率提高,远期复发率降低,值得临床推广。
Objective To observe the clinical efficacy of self-made Huayu water and Qi-qi and Shugan prescription combined with routine western medicine in the treatment of hepatitis B cirrhosis and ascites. Methods From January 2013 to June 2015, 110 patients with hepatitis B cirrhosis and ascites admitted to our hospital were randomly divided into combined treatment group and conventional western medicine group (n = 55). On the basis of routine western medicine treatment, Add self-made stasis water, Qi Shugan decoction oral. The course of treatment was 1 month and followed up for 6 months. The levels of ALT, AST, Alb and total bilirubin (TBil) were measured. Abdominal distension, loss of appetite, weakness, oliguria and lower extremity edema And jaundice and other symptoms and signs, as well as abdominal circumference and 24 h urine output changes after treatment evaluation of clinical efficacy. Results Compared with those before treatment, the number of symptoms and signs such as abdominal distension, loss of appetite, weakness, oliguria, lower extremity edema and jaundice were significantly decreased in both groups after treatment. The abdominal circumference of patients also decreased, The levels of ALT, AST, Alb and TBil were significantly improved. Comparing the two groups, the above symptoms and signs and laboratory indexes were significantly better in the combined treatment group than in the conventional western medicine group (P <0.05). The total effective rate of treatment group was higher than that of western medicine group (89.09% vs 74.55%, P <0.05); the recurrence rate of follow-up 6 months was lower in combination therapy group than in Western medicine group (10.91% vs 23.64% , P <0.05). Conclusions The self-made Huayu Lishui and YQSG prescription combined with conventional western medicine can effectively improve the main symptoms and signs of liver cirrhosis patients and laboratory indexes such as liver function, and the total effective rate is increased, the long-term recurrence rate is reduced, Worth clinical promotion.