Clinical effect of Zhigancao decoction combined with Zhuling decoction in treating ascites with cirrhosis
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摘要: [目的]观察经方炙甘草汤、猪苓汤联合治疗乙型肝炎肝硬化腹水的临床疗效。[方法]将30例中医辨证为精血不足、脾虚血瘀、水湿内停的乙型肝炎肝硬化腹水患者随机分为2组,对照组采用常规西医治疗方法(如限盐、保肝、利尿等),治疗组在对照组基础上加炙甘草汤合猪苓汤治疗,2组治疗1个月为1疗程。从Child-Pugh评分、血清白蛋白(ALB)、凝血功能(PT、PTA)及腹水动员方面评估2组治疗效果。[结果]在改善Child-Pugh评分方面:2组治疗后均能明显改善Child-Pugh评分(P<0.05),但治疗组在改善Child-Pugh评分方面优于对照组(P<0.01)。在提升ALB方面:治疗组治疗后能明显提高ALB (P<0.01),对照组治疗前后ALB变化不明显(P>0.05),且治疗组在提高ALB方面明显优于对照组(P<0.01)。在腹水动员方面:2组治疗后均能明显促进腹水动员(P<0.05),但治疗组明显优于对照组(P<0.01)。[结论]炙甘草汤合猪苓汤通过滋补肝肾、健脾益气活血、利水泄浊治疗乙型肝炎肝硬化腹水,在改善Child-Pugh、凝血功能方面有明显疗效,特别是提升ALB、动员腹水方面效果显著。Abstract: [Objective]:To observe the clinical effect of Zhigancao decoction combining Zhuling decoction in the treatment of ascites due to cirrhosis of hepatitis B.[Methods] 30 patients with liver cirrhosis and ascites with TCM syndrome of insufficiency of essence and blood, deficiency of spleen qi and blood stasis, and internal stasis of dampness and water were randomly divided into 2 groups.The control group was treated with conventional western medicine(such as salt restriction, liver function protecting drugs, diuretics);The treatment group was given Zhigancao decoction combining Zhuling decoction on the basis of the control group.Both groups were treated daily for one month.The therapeutic effects were evaluated in terms of Child-Pugh score, serum albumin(ALB) counts, coagulation function(PT, PTA) and ascites mobilization.[Results] Both groups received better Child-Pugh scores after the treatment(P<0.05), and the result in the treatment group was better than that in the control group(P<0.01).The treatment group received a better ALB counts after the treatment(P<0.05), while there was no significant differences shown before and after the treatment in the control group(P>0.05).In the aspect of mobilization of ascites, both groups received better results after the treatment(P<0.05), and the result in the treatment group was better than that in the control group(P<0.01).[Conclusion] Zhigancao decoction combining Zhuling decoction can obviously improve the efficacy of Child-Pugh and blood coagulation, especially enhance the ALB and mobilize the ascites in the patients of ascites due to cirrhosis of hepatitis B by the method of nourishing the Liver and Kidneys, invigorating the Spleen, replenishing qi and activating blood, and the effect is remarkable.
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Key words:
- hepatitis B cirrhosis /
- ascites /
- Zhigancao decoction /
- Zhuling decoction
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