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目的观察健脾利湿汤辅助治疗肝硬化腹水的临床疗效。方法将50例肝硬化腹水患者随机分为治疗组和对照组,各25例。对照组予抗病毒、护肝、抗肝纤维化、纠正低蛋白血症、利尿等治疗,治疗组在对照组治疗方法的基础上给予重用白术的健脾利湿汤口服,2组均治疗30 d。治疗前后检测并比较2组患者的生化指标,包括谷丙转氨酶(ALT)、谷草转氨酶(AST)、白蛋白(ALB)、总胆红素(TBIL);治疗后比较2组的临床疗效。结果与同组治疗前比较,2组治疗后ALT,AST,TBIL显著降低,ALB显著升高,差异均有统计学意义(P<0.05或P<0.01),且治疗组对各项指标的改善作用显著优于对照组,2组治疗后比较差异均有统计学意义(P<0.05);治疗组总有效率为92%,对照组为60%,2组比较差异有统计学意义(P<0.05),表明治疗组临床疗效显著优于对照组。结论健脾利湿汤辅助治疗肝硬化腹水(尤其是以低蛋白血症为主者)临床疗效较好,适宜在基层患者中推广应用。
Objective To observe the clinical efficacy of Jianpi Lishi Decoction in the treatment of ascites due to liver cirrhosis. Methods 50 cases of cirrhosis patients with ascites were randomly divided into treatment group and control group, 25 cases each. The control group was given anti-virus, liver protection, anti-liver fibrosis, hypoproteinemia, diuretic and other treatment, the treatment group in the control group based on the treatment of re-use of Atractylodes Rhizoma Pei-dampness oral administration, two groups were treated 30 d. The biochemical indexes including ALT, ALB, TBIL in two groups were detected and compared before and after treatment. The clinical effects of two groups were compared after treatment. Results Compared with the same group before treatment, ALT, AST, TBIL and ALB in the two groups were significantly decreased (P <0.05 or P <0.01), and the improvement of each index (P <0.05). The total effective rate was 92% in the treatment group and 60% in the control group, with significant difference between the two groups (P < 0.05), indicating that the clinical efficacy of treatment group was significantly better than the control group. Conclusion The adjuvant therapy of Jianpi Lishi Decoction in the treatment of cirrhosis and ascites (especially hypoproteinemia-based) has a good clinical effect and is suitable for promotion and application in primary patients.