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[目的]观察麝黄膏未时脐敷联合腹水超滤浓缩回输治疗顽固性肝硬化腹水疗效。[方法]使用随机平行对照方法,将120例住院患者按病志号抽签方法简单随机分为两组。对照组60例WLFHY2500型电脑腹水超滤浓缩回输系统,一次性滤出液体3000~8000m L,1次/周。治疗组60例麝黄膏(田螺30g,麝香1g,人工牛黄1g,葱白、甘遂各10g),取本方葱白榨汁,甘遂加水煎煮2次,2h/次,合并,与葱白汁混合过滤,浓缩成相对密度为1120的稠膏,放冷,备用;麝香、人工牛黄用95%乙醇回流提取3次,回收乙醇至适量;田螺肉粉碎,去渣,蒸制消毒;将麝香、牛黄提液和田螺制品加入稠膏混匀,密封,制成3cm×3cm巴布帖,1贴/次,1次/d,未时(13~15时)外敷脐部;腹水超滤浓缩回输治疗同对照组。连续治疗1个月为1疗程。观测临床症状、体重、腹围、24h尿量、不良反应。连续治疗6疗程,判定疗效。[结果]治疗3个月,治疗组Ⅰ级14例,Ⅱ级15例,Ⅲ级11例,无效20例,总有效率66.60%。对照组Ⅰ级1例,Ⅱ级2例,Ⅲ级9例,无效48例,总有效率20.00%。治疗6个月,治疗组Ⅰ级15例,Ⅱ级15例,Ⅲ级12例,无效18例,总有效率70.00%。对照组Ⅰ级0例,Ⅱ级0例,Ⅲ级9例,无效51例,总有效率15.00%。治疗组疗效优于对照组(P<0.01)。[结论]麝黄膏未时脐敷联合腹水超滤浓缩回输治疗顽固性肝硬化腹水,疗效满意,无副作用,值得推广。
[Objective] To observe the curative effect of intramuscular ascites treated with umbilical cord combined with ultrafiltration of dextran and decontamination. [Method] Using randomized parallel control method, 120 inpatients were randomly divided into two groups randomly according to the method of lot drawing of disease symbols. Control group, 60 cases of WLFHY2500 computer ascites ultrafiltration concentrated infusion system, a one-time filter out the liquid 3000 ~ 8000m L, 1 times / week. The treatment group of 60 cases of musk deer cream (snail 30g, musk 1g, artificial bezoar 1g, light blue, kansui each 10g), take the onion white juice, add water and boiling for 2 times, 2h / times, Mixed and filtered, concentrated to a relative density of 1120 thick paste, let cool, spare; musk, artificial bezoar with 95% ethanol reflux extraction three times to recover ethanol to the right amount; snail meat crushed to slag, steaming disinfection; musk, Bezoar extract and snail products were added thick paste, sealed, made of 3cm × 3cm Babu Tie, 1 paste / time, 1 time / d, before (13 ~ 15 hours) topical umbilical; ascites ultrafiltration concentrated back Lose treatment with the control group. Continuous treatment for 1 month for a course of treatment. Observation of clinical symptoms, weight, abdominal circumference, 24h urine output, adverse reactions. Continuous treatment of 6 courses to determine the efficacy. [Result] The treatment group had 14 cases of grade Ⅰ, 15 cases of grade Ⅱ, 11 cases of grade Ⅲ and 20 cases ineffective, with a total effective rate of 66.60%. In control group, there were 1 case of grade Ⅰ, 2 cases of grade Ⅱ, 9 cases of grade Ⅲ, 48 cases were ineffective and the total effective rate was 20.00%. Treatment for 6 months, the treatment group Ⅰ 15 cases, Ⅱ 15 cases, Ⅲ grade 12 cases, 18 cases ineffective, the total effective rate 70.00%. There were 0 cases in grade Ⅰ, 0 cases in grade Ⅱ, 9 cases in grade Ⅲ, and 51 cases were ineffective. The total effective rate was 15.00%. The treatment group than the control group (P <0.01). [Conclusion] The results showed that dextran combined with Umbilical cord ascites and ultrafiltration of ascites were delivered to patients with refractory cirrhosis and ascites, with satisfactory curative effect and no side effects, which deserved promotion.