实胀方与虚胀方辨证敷脐对肝硬化腹水的作用

作者	单位
刘成海	上海中医药大学附属曙光医院
张雅丽	上海中医药大学附属曙光医院
冯年平	上海中医药大学中药学院
蔡俊萍	上海中医药大学附属曙光医院
薛惠明	上海中医药大学附属曙光医院
史美育	上海中医药大学文献研究所
陈建杰	上海中医药大学附属曙光医院

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中文摘要:

目的探讨中药实胀方与虚胀方巴布剂敷脐分别对肝硬化腹水实证与虚证患者的作用。方法选择肝硬化腹水住院患者77例,其中实证37例,随机分为对照组11例、试验组26例;虚证40例,随机分为对照组14例、试验组26例。在限制利尿剂使用的一般治疗基础上,试验组实证与虚证分别以实胀方或虚胀方巴布剂敷脐,对照组不用敷脐药物。观察患者症状、体重、腹围与尿量,治疗前后B超检查腹水情况,分级判断疗效。并观察毒副反应。结果实际完成病例62例,脱落15例。与相应对照组比较,试验组体重减轻,腹围缩小,腹水减少,而且尿量与排气明显增加(P<0.05)。试验组的综合疗效明显优于对照组(P<0·05),其中虚证对照与试验组的Ⅰ/Ⅱ级有效率分别为7.1%、57.2%,实证对照与试验组分别为9·1%、69·2%,以实证敷脐试验组疗效稍好。结论中药实胀方与虚胀方巴布剂敷脐分别对肝硬化腹水实证与虚证患者有良好的辅助治疗作用。

英文摘要:

ObjectiveTo investigate the effects of Shizhang Cataplasm (SC) and Xuzhang Cataplasm (XC) in treating liver cirrhosis caused ascites of excessive syndrome (ES) type and deficient syndrome (DS) type respectively. MethodsAll the 77 patients (37 of ES type and 40 of DS type) enrolled were treated by conventional treatment but with restrictive use of diuretics. SC and XC were given respectively to 26 patients of ES type and 26 of DS type additionally by umbilical sticking, they were regarded as the treated group, and those (11 of ES type and 14 of DS type) not received the cataplasm treatment were regarded as the control group. The changes of symptoms, body weight, abdominal perimeter and amount of urine before and after treatment were observed, and amount of ascites was examined with B-ultrasound to evaluate the efficacy according to comprehensive grading criteria. Also, the toxicity was observed. ResultsSixty-two cases completed the full course, 15 were withdrawn. As compared with the corresponding control group, body weight, abdominal perimeter and amount of ascites decreased, while amount of urine and flatus discharging increased remarkably in the treated group (P<0.05). The comprehensive efficacy in patients of ES type was better than that in DS type (P<0.05). The effective rate of grade Ⅰ/Ⅱ was 7.1% and 9.1% for patients in the control group of DS type and ES type respectively, while it was 57.2% and 69.2% in the treated group of DS and ES type respectively. Better therapeutic effect was shown in patients of ES type treated with SC. ConclusionSC and XC showed good assistant effects in treating patients with liver cirrhosis caused ascites of ES and DS type respectively.

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