调肝健脾补肾为主组方治疗肝硬化腹水的临床疗效观察
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摘要
目的:
观察以调肝健脾补肾作用为主组成的中药方治疗肝硬化腹水的临床疗效和不良反应,客观评价其治疗肝硬化腹水的有效性和安全性,并初步探讨其作用机制,为临床治疗肝硬化腹水提供有益的参考。
方法:
所有病例均为2007年5月至2008年4月湖北中医学院第一附属医院肝病科住院病房收治的,符合肝硬化腹水诊断标准的合格受试者,共60例,随机分为治疗组和对照组。治疗组30例,采用中药方配合常规西医对症治疗;对照组30例,采用常规西医对症治疗。必要时两组均予以腹腔穿刺抽取腹水减压治疗。二周为一疗程,共两个疗程。
于治疗前后各记录一次患者主要症状、体征(腹胀、尿少、乏力、纳差、黄疸、双下肢浮肿)、肝功能、体重、腹围、腹部B超检查(脾脏厚度、门静脉及脾静脉宽度)及其治疗后并发症的情况,并监测24h尿量,根据相应诊疗标准,作出疗效评价;于治疗前后观察一般体格检查项目(如T、P、R、BP)、血常规、尿常规、粪常规及肾功能、心电图及不良反应,作出安全性评价。
观察结束后,将所有数据进行统计分析,所有统计检验均采用双侧检验。计量型数据采用均数±标准差((?)±s)进行统计描述,计量资料采用t检验,计数资料采用X~2检验。P＞0.05表示检验无显著性差异,P＜0.05表示检验有显著性差异,P＜0.01表示检验有非常显著性差异。
结果:
1总疗效比较:治疗组总有效率93.3%,对照组总有效率70.0%,两组比较有显著性差异(P＜0.05),表明治疗组治疗肝硬化腹水有更好的临床总疗效。
2两组患者主要症状、体征改善比较:治疗组症状、体征改善明显,优于对照组,统计分析有显著性差异(P＜0.05);治疗组治疗前后对比及对照组治疗前后对比,均有显著性差异(P＜0.05)。
3两组患者肝功能、凝血酶原活动度比较:治疗组肝功能、凝血酶原活动度改善明显,优于对照组,统计分析有显著性差异(P＜0.05);治疗组治疗前后对比及对照组治疗前后对比,均有显著性差异(P＜0.05)。
4两组患者体重、腹围、平均24h尿量比较:治疗组治疗前后体重、腹围、平均24h尿量变化明显,优于对照组,统计分析有显著性差异(P＜0.05);治疗组治疗前后对比有显著性差异(P＜0.05);对照组治疗前后平均24h尿量比较有显著性差异(P＜0.05),但体重、腹围变化不明显,无显著性差异(P＞0.05)。
5两组患者腹部B超(脾脏厚度、门静脉及脾静脉宽度)比较:治疗组治疗前后腹部B超(脾脏厚度、门静脉及脾静脉宽度)变化明显,优于对照组,有非常显著性差异(P＜0.01);治疗组治疗前后对比有显著性差异(P＜0.05):对照组治疗前后对比无显著性差异(P＞0.05)。
6两组患者治疗后并发症情况比较:两组患者治疗后并发症例数,治疗组明显少于对照组,比较有显著性差异(P＜0.05)。
7安全性比较:两组患者治疗后一般体格检查、血常规、尿常规、粪常规及肾功能、心电图检测均无明显异常变化;治疗过程中及治疗结束后亦无不良反应出现,表明中药方治疗肝硬化腹水安全有效,无明显毒副作用。
结论:
临床观察表明:治疗组所采用的中药方治疗肝硬化腹水疗效肯定,在改善患者症状、体征、肝功能等方面优于对照组,且减少了各种并发症的发生,减轻了患者痛苦,提高了患者生存生活质量,同时安全,经济,为我们临床治疗肝硬化腹水提供了有益的参考。
Objective:
To observe the clinical curative effect and blight of the formula which primarily be composed of adjusting the liver,invigorating the spleen and nourishing the kidney to treat liver cirrhosis ascites,objectively evaluates its validity and security of treating liver cirrhosis ascites, and discusses its function mechanism initially,to provide the beneficial reference for clinical treating liver cirrhosis ascites.
Methods:
All cases of illness which admited to the liver branch ward in the first affiliated hospital of Hubei TCM College were from May,2007 to April, 2008,conformed to the diagnosis standard of liver cirrhosis ascites, altogether 60 examples,divided into the treatment group and the control group stochastically.The treatment group 30 examples,used the formula coordinating conventional western medicine to treat just right for the illness;the control group 30 examples,used the conventional western medicine to treat just right for the illness.When necessity two groups gived the abdominal puncture to extract ascites for treatment of reducing pressure.Two weeks were a treatment course,altogether two treatment courses.
Recorded the main symptoms,the symptom(distension of the abdomen, few urine,asthenia,accepts difference,jaundice,edema of the double lower limbs),the liver function,the body weight,the abdomen encircle, the abdomen B ultrasonic inspection(spleen thickness,portal vein and spleen vein width)a time respectively before and after the treatment and the complication situation after the treatment,and monitored the 24h amount of urine,according to the corresponding standard of diagnosing and treating,maked the curative effect appraisal;observed the general medical examination for the body(for example T,P,R,BP),blood routine test,urine routine test,stool routine test and kidney function,the electrocardiogram and untoward effect a time respectively before and after the treatment,maked the secure appraisal.
After the observation had ended,possessed all the data to carry on the statistical analysis,all statistical test used the two-sided test. The measurement data used the mean value±standard deviation((?)±s) to carry on the statistical description,the measurement date used the T-test,the counting date used the chi-square test.P＞0.05 had the non-significance difference,P＜0.05 had the significance difference,P＜0.01 had the unusual significance difference.
Results:
1 Total effect comparison:Treatment group total efficient 93.3%,control group total efficient 70.0%,two groups have the significance difference(P＜0.05),indicating that the treatment group have a better clinical total effect for reating liver cirrhosis ascites.
2 Two groups of patients main symptoms,symptom improvement comparison: The treatment group symptoms,symptom improvement are obvious,surpasses the control group,the statistical analysis has the significance difference(P＜0.05);the comparison before and after treatment the treatment group and the control group all have the significance difference (P＜0.05).
3 Two groups of patients liver functions,zymoplasm activity comparison:The treatment group liver function,the zymoplasm activity improvement is obvious,surpasses the control group,the statistical analysis has the significance difference(P＜0.05);the comparison before and after treatment the treatment group and the control group all have the significance difference(P＜0.05).
4 Two groups of patients body weights,abdomen encircle,the average 24h amount of urine comparison:Before and after treatment the treatment group body weight,abdomen encircles,the average 24h amount of urine change obviously,surpasses the control group,the statistical analysis has the significance difference(P＜0.05);the comparison before and after treatment the treatment group has the significance difference(P＜0.05); the average 24h amount of urine comparison before and after treatment the control group has the significance difference(P＜0.05),but body weight, abdomen encircle change not obviously,non-significance difference (P＞0.05).
5 Two groups of patients abdomen Bultrasonic(spleen thickness,portal vein and spleen vein width)comparison:Before and after treatment the treatment group abdomen Bultrasonic(spleen thickness,portal vein and the spleen vein width)changes obviously,surpasses the control group, has the unusual significance difference(P＜0.01);the comparison before and after treatment the treatment group has the significance difference (P＜0.05);the comparison before and after treatment the control group treats has the non-significance difference(P＞0.05).
6 After treatment two groups of patients the complication situation comparison:After treatment two groups of patients the complication examples,the treatment group is fewer obviously than the control group, has the significance difference(P＜0.05).
7 Security comparisons:After treatment two groups of patients the general medical examination for the body,blood routine test,urine routine test,stool routine test and kidney function,electrocardiogram examination all not obviously change;in the course of treatment and after treatment,also no untoward effect appears,indicating that the formula is safe and has no obvious poisonous side effect for treating liver cirrhosis ascites.
Conclusion:
The clinical observation indicate that:The treatment group using the formula to treat liver cirrhosis ascites is curative which be affirmed, improving patient symptoms,symptom,liver function and so on surpasses the control group,also reduces complication occurrence,reduces the patient pain,enhances the quality of life which the patient to survive, and security,the economy simultaneously,provides the beneficial reference for us to treate liver cirrhosis ascites.
观察以调肝健脾补肾作用为主组成的中药方治疗肝硬化腹水的临床疗效和不良反应,客观评价其治疗肝硬化腹水的有效性和安全性,并初步探讨其作用机制,为临床治疗肝硬化腹水提供有益的参考。
方法:
所有病例均为2007年5月至2008年4月湖北中医学院第一附属医院肝病科住院病房收治的,符合肝硬化腹水诊断标准的合格受试者,共60例,随机分为治疗组和对照组。治疗组30例,采用中药方配合常规西医对症治疗;对照组30例,采用常规西医对症治疗。必要时两组均予以腹腔穿刺抽取腹水减压治疗。二周为一疗程,共两个疗程。
于治疗前后各记录一次患者主要症状、体征(腹胀、尿少、乏力、纳差、黄疸、双下肢浮肿)、肝功能、体重、腹围、腹部B超检查(脾脏厚度、门静脉及脾静脉宽度)及其治疗后并发症的情况,并监测24h尿量,根据相应诊疗标准,作出疗效评价;于治疗前后观察一般体格检查项目(如T、P、R、BP)、血常规、尿常规、粪常规及肾功能、心电图及不良反应,作出安全性评价。
观察结束后,将所有数据进行统计分析,所有统计检验均采用双侧检验。计量型数据采用均数±标准差((?)±s)进行统计描述,计量资料采用t检验,计数资料采用X~2检验。P＞0.05表示检验无显著性差异,P＜0.05表示检验有显著性差异,P＜0.01表示检验有非常显著性差异。
结果:
1总疗效比较:治疗组总有效率93.3%,对照组总有效率70.0%,两组比较有显著性差异(P＜0.05),表明治疗组治疗肝硬化腹水有更好的临床总疗效。
2两组患者主要症状、体征改善比较:治疗组症状、体征改善明显,优于对照组,统计分析有显著性差异(P＜0.05);治疗组治疗前后对比及对照组治疗前后对比,均有显著性差异(P＜0.05)。
3两组患者肝功能、凝血酶原活动度比较:治疗组肝功能、凝血酶原活动度改善明显,优于对照组,统计分析有显著性差异(P＜0.05);治疗组治疗前后对比及对照组治疗前后对比,均有显著性差异(P＜0.05)。
4两组患者体重、腹围、平均24h尿量比较:治疗组治疗前后体重、腹围、平均24h尿量变化明显,优于对照组,统计分析有显著性差异(P＜0.05);治疗组治疗前后对比有显著性差异(P＜0.05);对照组治疗前后平均24h尿量比较有显著性差异(P＜0.05),但体重、腹围变化不明显,无显著性差异(P＞0.05)。
5两组患者腹部B超(脾脏厚度、门静脉及脾静脉宽度)比较:治疗组治疗前后腹部B超(脾脏厚度、门静脉及脾静脉宽度)变化明显,优于对照组,有非常显著性差异(P＜0.01);治疗组治疗前后对比有显著性差异(P＜0.05):对照组治疗前后对比无显著性差异(P＞0.05)。
6两组患者治疗后并发症情况比较:两组患者治疗后并发症例数,治疗组明显少于对照组,比较有显著性差异(P＜0.05)。
7安全性比较:两组患者治疗后一般体格检查、血常规、尿常规、粪常规及肾功能、心电图检测均无明显异常变化;治疗过程中及治疗结束后亦无不良反应出现,表明中药方治疗肝硬化腹水安全有效,无明显毒副作用。
结论:
临床观察表明:治疗组所采用的中药方治疗肝硬化腹水疗效肯定,在改善患者症状、体征、肝功能等方面优于对照组,且减少了各种并发症的发生,减轻了患者痛苦,提高了患者生存生活质量,同时安全,经济,为我们临床治疗肝硬化腹水提供了有益的参考。
Objective:
To observe the clinical curative effect and blight of the formula which primarily be composed of adjusting the liver,invigorating the spleen and nourishing the kidney to treat liver cirrhosis ascites,objectively evaluates its validity and security of treating liver cirrhosis ascites, and discusses its function mechanism initially,to provide the beneficial reference for clinical treating liver cirrhosis ascites.
Methods:
All cases of illness which admited to the liver branch ward in the first affiliated hospital of Hubei TCM College were from May,2007 to April, 2008,conformed to the diagnosis standard of liver cirrhosis ascites, altogether 60 examples,divided into the treatment group and the control group stochastically.The treatment group 30 examples,used the formula coordinating conventional western medicine to treat just right for the illness;the control group 30 examples,used the conventional western medicine to treat just right for the illness.When necessity two groups gived the abdominal puncture to extract ascites for treatment of reducing pressure.Two weeks were a treatment course,altogether two treatment courses.
Recorded the main symptoms,the symptom(distension of the abdomen, few urine,asthenia,accepts difference,jaundice,edema of the double lower limbs),the liver function,the body weight,the abdomen encircle, the abdomen B ultrasonic inspection(spleen thickness,portal vein and spleen vein width)a time respectively before and after the treatment and the complication situation after the treatment,and monitored the 24h amount of urine,according to the corresponding standard of diagnosing and treating,maked the curative effect appraisal;observed the general medical examination for the body(for example T,P,R,BP),blood routine test,urine routine test,stool routine test and kidney function,the electrocardiogram and untoward effect a time respectively before and after the treatment,maked the secure appraisal.
After the observation had ended,possessed all the data to carry on the statistical analysis,all statistical test used the two-sided test. The measurement data used the mean value±standard deviation((?)±s) to carry on the statistical description,the measurement date used the T-test,the counting date used the chi-square test.P＞0.05 had the non-significance difference,P＜0.05 had the significance difference,P＜0.01 had the unusual significance difference.
Results:
1 Total effect comparison:Treatment group total efficient 93.3%,control group total efficient 70.0%,two groups have the significance difference(P＜0.05),indicating that the treatment group have a better clinical total effect for reating liver cirrhosis ascites.
2 Two groups of patients main symptoms,symptom improvement comparison: The treatment group symptoms,symptom improvement are obvious,surpasses the control group,the statistical analysis has the significance difference(P＜0.05);the comparison before and after treatment the treatment group and the control group all have the significance difference (P＜0.05).
3 Two groups of patients liver functions,zymoplasm activity comparison:The treatment group liver function,the zymoplasm activity improvement is obvious,surpasses the control group,the statistical analysis has the significance difference(P＜0.05);the comparison before and after treatment the treatment group and the control group all have the significance difference(P＜0.05).
4 Two groups of patients body weights,abdomen encircle,the average 24h amount of urine comparison:Before and after treatment the treatment group body weight,abdomen encircles,the average 24h amount of urine change obviously,surpasses the control group,the statistical analysis has the significance difference(P＜0.05);the comparison before and after treatment the treatment group has the significance difference(P＜0.05); the average 24h amount of urine comparison before and after treatment the control group has the significance difference(P＜0.05),but body weight, abdomen encircle change not obviously,non-significance difference (P＞0.05).
5 Two groups of patients abdomen Bultrasonic(spleen thickness,portal vein and spleen vein width)comparison:Before and after treatment the treatment group abdomen Bultrasonic(spleen thickness,portal vein and the spleen vein width)changes obviously,surpasses the control group, has the unusual significance difference(P＜0.01);the comparison before and after treatment the treatment group has the significance difference (P＜0.05);the comparison before and after treatment the control group treats has the non-significance difference(P＞0.05).
6 After treatment two groups of patients the complication situation comparison:After treatment two groups of patients the complication examples,the treatment group is fewer obviously than the control group, has the significance difference(P＜0.05).
7 Security comparisons:After treatment two groups of patients the general medical examination for the body,blood routine test,urine routine test,stool routine test and kidney function,electrocardiogram examination all not obviously change;in the course of treatment and after treatment,also no untoward effect appears,indicating that the formula is safe and has no obvious poisonous side effect for treating liver cirrhosis ascites.
Conclusion:
The clinical observation indicate that:The treatment group using the formula to treat liver cirrhosis ascites is curative which be affirmed, improving patient symptoms,symptom,liver function and so on surpasses the control group,also reduces complication occurrence,reduces the patient pain,enhances the quality of life which the patient to survive, and security,the economy simultaneously,provides the beneficial reference for us to treate liver cirrhosis ascites.
引文
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