七消饮加味配合中药溻渍治疗肝硬化腹水（气虚血瘀证）的临床观察

发布时间：2018-05-06 01:21

本文选题：七消饮加味 + 中药溻渍　；参考：《长春中医药大学》2016年硕士论文

【摘要】：目的:本课题采用“益气化瘀,利水消鼓”的治法,应用自拟方七消饮加味配合中药溻渍治疗肝硬化腹水(气虚血瘀证),通过临床观察,客观评价七消饮加味配合中药溻渍治疗肝硬化腹水(气虚血瘀证)的安全性及有效性。为肝硬化腹水规范的治疗方案寻求更为有利的依据。方法:对就诊于我院肝脾胃病科病房肝硬化腹水(气虚血瘀证)的符合条件的72例患者按照随机分组原则将其分为2组,其中对照组36例,治疗组36例,两组患者均治疗4周。对照组给予保肝降酶药物静点、利尿剂口服。治疗组在对照组的基础上加用中药七消饮加味配合红外线照射中药溻渍腹部疗法。治疗四周后,通过记录治疗前、后患者的体重、腹围、腹水彩超、肝功能、主要症状及次要症状等的改善情况。以分析总结出七消饮加味配合中药溻渍治疗肝硬化腹水(气虚血瘀证)的有效性及安全性。结果:1)、安全性观察:对两组患者治疗前后安全性指标进行观察,显示两组患者在治疗的过程中均未出现任何不良事件。2)、总体疗效比较:对照组36例患者,其中临床治愈6例,显效10例,有效16例,无效4例。治疗组36例患者临床治愈10例,显效18例,有效6例,无效2例。对照组临床治愈率16.7%,显效率27.8%,有效率44.4%,无效率:11.1%。治疗组临床治愈率27.8%,显效率50%,有效率16.6%,无效率:5.6%。对照组总有效率:88.9%,治疗组总有效率:94.4%。治疗组效果优于对照组,且具有统计学意义(P0.05)。3)、治疗后中医单项症状的改善:面色晦暗这一症状的改善,两组治疗效果未见明显的统计学差异(P0.05)。但是,在腹大胀满、神疲乏力、头颈胸间紫斑、食后腹胀、小便短少这5个症状改善方面,治疗组的效果明显优于对照组,有统计学意义(P0.05)。4)、治疗后各项疗效指标比较:在降低门静脉内径方面两组治疗效果未见明显的统计学差异(P0.05),但是两组患者在改善肝功能(TBIL、ALT、AST、GGT、ALB)、缩小腹围、减轻体重、增加24小时尿量、减低彩超下腹水量方面,治疗组效果明显优于对照组,有统计学差异(P0.05)。结论:由以上数据经过分析得出:七消饮加味配合中药溻渍治疗肝硬化腹水(气虚血瘀证)在消退腹水,改善肝功能各项指标,缓解症状等方面安全有效。进一步客观评价了七消饮加味配合中药溻渍治疗肝硬化腹水(气虚血瘀证)的安全性及疗效,从而证明了其在治疗肝硬化腹水(气虚血瘀证)方面的优势。
[Abstract]:Objective: to use the method of "invigorating qi and removing blood stasis, and promoting water to remove the drum", and to treat ascites of liver cirrhosis (Qi deficiency and blood stasis syndrome) with modified Qixiao decoction and traditional Chinese medicine, and to observe it through clinical observation. Objective to evaluate the safety and efficacy of Qixiaoyin Jiawei combined with traditional Chinese medicine in the treatment of ascites of liver cirrhosis (qi deficiency and blood stasis syndrome). To find a more favorable basis for the standard treatment of ascites due to cirrhosis. Methods: 72 patients with cirrhotic ascites (Qi deficiency and blood stasis syndrome) were randomly divided into two groups: control group (36 cases), treatment group (36 cases) and treatment group (36 cases). The control group was treated with liver protection drug and diuretic orally. On the basis of the control group, the treatment group was treated with traditional Chinese medicine Qixiaoyin plus infrared radiation. After four weeks of treatment, the improvement of weight, abdominal circumference, ascites color Doppler ultrasound, liver function, main symptoms and secondary symptoms were recorded before and after treatment. The efficacy and safety of Qixiaoyin Jiawei combined with traditional Chinese medicine Tarim stains in treating ascites of liver cirrhosis (qi deficiency and blood stasis syndrome) were summarized. Results: the safety indexes of the two groups of patients before and after treatment were observed. The results showed that there were no adverse events in both groups. The overall curative effect was compared: 36 patients in the control group, 6 patients were clinically cured. There were 10 cases of remarkable effect, 16 cases of effective and 4 cases of failure. In the treatment group, 10 cases were clinically cured, 18 cases were effective, 6 cases were effective and 2 cases were ineffective. In the control group, the clinical cure rate was 16.7g, the apparent efficiency was 27.8m, the effective rate was 44.4, and the inefficiency was: 11.1. In the treatment group, the clinical cure rate was 27.8%, the markedly effective rate was 50%, the effective rate was 16.6b, and the inefficiency was 5.6%. The total effective rate of the control group was 88.9 and the total effective rate of the treatment group was 94.4. The effect of the treatment group was better than that of the control group, and it had statistical significance (P 0.05). After treatment, the single symptom of TCM was improved: the symptom of dark complexion was improved, and there was no significant difference in the treatment effect between the two groups (P 0.05). However, the effect of the treatment group was significantly better than that of the control group in the five symptoms of abdominal bulge, fatigue, purple spots between the head, neck and chest, abdominal distension after eating and short urination. There was no significant difference in the therapeutic effect between the two groups in reducing the diameter of portal vein after treatment. However, the two groups were improving liver function by TBILALTASTASTGGTT ALB, reducing abdominal circumference, reducing body weight, and increasing 24 hours urine volume, and compared with the control group, the patients in the two groups had no significant difference in the effect of treatment on reducing the diameter of portal vein (P0. 05%, P 0. 05%, P 0. 05%, P 0. 05%, P 0. 05, P 0. 05). The effect of the treatment group was better than that of the control group (P 0.05). Conclusion: through the analysis of the above data, it is concluded that Qixiaoyin Jiawei combined with traditional Chinese medicine Tarim stains is safe and effective in the treatment of ascites of liver cirrhosis (qi deficiency and blood stasis syndrome), improving various indexes of liver function and alleviating symptoms. The safety and curative effect of Qixiaoyin Jiawei combined with traditional Chinese medicine Tarim stains in treating ascites of liver cirrhosis (Qi deficiency and blood stasis syndrome) were evaluated objectively, which proved its superiority in treating cirrhosis ascites (Qi deficiency and blood stasis syndrome).
【学位授予单位】：长春中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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