脐火疗法治疗脾肾阳虚型肝硬化腹水的临床研究

发布时间：2018-06-13 13:18

本文选题：肝硬化 + 腹水　；参考：《河南中医药大学》2016年硕士论文

【摘要】：目的:通过比较脾肾阳虚型肝硬化腹水患者试验组和对照组治疗前后超声腹水定量、中医证候、腹围、体重及肝功能等临床指标变化,观察脐火疗法治疗脾肾阳虚型肝硬化腹水的临床疗效,为治疗肝硬化腹水探索新方法,扩大脐火疗法的适应范围。方法:选取符合本研究纳入标准的脾肾阳虚型肝硬化腹水患者60例为研究对象,按1:1的比例随机分为2组,即试验组与对照组,各30例。对照组采用西医基础治疗与中药颗粒剂口服的内治方案;试验组在此基础上加用脐火疗法,疗程1个月,3个月后随访。观察60例患者治疗前后彩超腹水深度、中医证候、腹围、体重、肝功能等指标的变化情况。结果:1对腹水量的影响:治疗后试验组与对照组腹水量均明显减少(P05.0),两组患者治疗前后腹水量差值比较,试验组减少更为明显(P05.0)。2对腹围的影响:治疗后两组患者的腹围均明显减小(P05.0),两组治疗后腹围差值比较,减小程度无差异(P05.0)。3对体重的影响:治疗后两组患者的体重均明显减轻(P05.0),两组治疗前后体重差值比较,试验组减轻更为明显(P05.0)。4对中医各症状的影响:两组治疗后各症状均明显改善(P05.0),试验组在便溏、畏寒肢冷、尿量改善方面,疗效更明显(P05.0)。5对中医证候积分的影响:两组患者治疗后中医证候积分均有明显下降,两组治疗后中医证候疗效分级比较,试验组改善中医证候疗效更明显(P05.0)。6综合疗效评价结果:治疗后综合评价两组患者均有较好疗效,两组患者综合疗效分级比较,试验组总体疗效优于对照组(P05.0)。7对血ALT、AST的影响:治疗后两组血ALT、AST水平均有明显下降(P05.0),但两组治疗前后血ALT差值、AST差值比较,下降程度无差异(P05.0)。8对血TBIL、ALB的影响:治疗后两组患者血TBIL水平均有下降,血ALB水平均有增加(P05.0),两组治疗前后血TBIL差值比较,试验组下降程度更明显,血ALB差值比较,试验组增加程度更为明显(P05.0)。结论:1脐火疗法的应用可使脾肾阳虚型肝硬化腹水患者腹水量减少、体重减轻、便溏、畏寒肢冷、尿量改善,提高肝硬化腹水的总体疗效。2脐火疗法可使脾肾阳虚型肝硬化腹水患者的血清总胆红素下降、血清白蛋白增加。
[Abstract]:Objective: to compare the changes of ultrasonic ascites quantity, TCM syndromes, abdominal circumference, body weight and liver function before and after treatment in experimental group and control group of cirrhotic ascites with deficiency of spleen and kidney yang. To observe the clinical effect of umbilical fire therapy on ascites of liver cirrhosis with deficiency of spleen and kidney yang, to explore a new method for treating ascites of liver cirrhosis, and to expand the scope of application of umbilical fire therapy. Methods: sixty cirrhotic ascites patients with spleen and kidney yang deficiency type were selected and randomly divided into two groups according to the 1:1 ratio: the experimental group and the control group, 30 cases each. The control group was treated with western medicine and Chinese traditional medicine granules orally, and the experimental group was treated with navel fire therapy for 1 month and followed up after 3 months. The changes of ascites depth, TCM syndrome, abdominal circumference, body weight and liver function were observed in 60 patients before and after treatment. Results the effect of 1 / 1 on ascites volume: after treatment, the ascites volume in the experimental group and the control group were significantly reduced, and the difference of ascites volume between the two groups was compared before and after treatment. The effect of P05.0 / 2 on abdominal circumference was more obvious in the trial group: after treatment, the abdominal circumference of the two groups was significantly reduced, and the difference of the abdominal circumference between the two groups was compared. There was no difference in the degree of reduction between the two groups. The weight difference between the two groups before and after treatment was significantly lower than that in the control group, and the difference between the two groups before and after treatment was higher than that in the control group. In the test group, the effects of P05.0 / 4 on the symptoms of traditional Chinese medicine were alleviated: the symptoms of the two groups were obviously improved after treatment, while in the test group, the stools, cold limbs and urine volume were improved. The effect of P05.00.5on TCM syndromes score was more obvious: the scores of TCM syndromes in two groups were obviously decreased after treatment, and the curative effects of TCM syndromes in the two groups were compared after treatment. The effect of improving TCM syndromes in the test group was more obvious than that in the control group. The results of comprehensive curative effect evaluation were as follows: after the treatment, the two groups had better curative effect, and the two groups were compared with each other in the comprehensive curative effect grade. The total curative effect of the trial group was better than that of the control group (P05.00.7). After treatment, the level of alt was significantly decreased in both groups, but the difference between the two groups was compared before and after treatment. There was no difference in the degree of decrease of serum TBIL between the two groups: after treatment, the level of TBIL in both groups was decreased, and the level of serum ALB was increased in both groups. The difference of TBIL between the two groups before and after treatment was more obvious, and the difference of serum ALB was more obvious. The increasing degree of the test group was more obvious than that of the control group (P05.0). Conclusion the application of W1 navel fire therapy can reduce ascites quantity, weight loss, loose stools, cold limbs and improved urine volume in patients with liver cirrhosis and ascites with deficiency of spleen and kidney yang. The total bilirubin and serum albumin were decreased and serum albumin was increased in cirrhotic ascites patients with spleen and kidney yang deficiency.
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

【相似文献】