肝炎肝硬化低蛋白血症的中医证候特点及疗效分析

目的探讨肝炎肝硬化低蛋白血症的中医证候特点与疗效。方法对69例患者进行辨证分型，统计分析这类患者的证候学特点，并按数字表法随机将其分为3组。治疗1组22例，在基础治疗上加服茯白方，12周为1个疗程；治疗2组23例，在基础治疗上也加服茯白方，但24周为1个疗程；对照组24例，仅用一般基础治疗，观察治疗12，24周中医证候、血清白蛋白变化情况。结果以脾胃虚弱证、气滞血瘀证、肝。肾阴虚证最为常见，其次是脾虚湿盛证，脾’肾阳虚证出现最少；并且同一患者可有几个证型重叠，以脾胃虚弱证与气滞血瘀证、肝肾阴虚证重叠最为常见。经中药茯白方治疗后，血清白蛋白及症状、体征均得到改善。结论肝炎肝硬化低蛋白血症患者的中医证候特点是以脾虚、生化乏源，肝肾同源、肾精受损为其本，又以痰瘀毒交阻、脉络阻滞为其标。中药茯白方不仅能改善患者症状，更能提高血清白蛋白含量，且中远期疗效更为显著且持久。

TCM syndrome characteristics of hypoproteinemia induced by hepatitis cirrhosis and curative effect of Chinese medicines

Objective To study the TCM syndrome characteristics of hypoproteinemia induced by hepatitis cirrhosis and curative effect of Chinese medicine. Method The syndrome differentiation and classification was given to 69 patients. The TCM syndrome characteristics in these patients were calculated and analysed. All patients were randomly divided into 3 groups according to the method of random number table. Group 1 （treatment group 1, n=22） was treated with Fubai Formula after basic treatment for 12 weeks, group 2 （treatment group 2, n=23） was treated with Fubai Formula after basic treatment for 24 weeks, and group 3 （control group, n=24） was treated with basic treatment only. The changes of TCM syndromes and serum albumin were observed respectively ＂after the treatment for 12 or 24 weeks. Result The most common syndromes included spleen-stomach weakness syndrome, qi stagnation and blood stasis syndrome, and liver-kidney yin deficiency, and common ones included the syndrome of spleen deficiency and exuberant dampness. The least one was spleen-kidney yang deficiency syndrome. A patient might have multiple syndromes at the same time, especially spleen-stomach weakness syndrome combined with the syndrome of qi stagnation and blood stasis or liver- kidney yin deficiency. After the treatment with Fubai Formula the content of serum albumin, symptoms and signs were improved or relieved in the patients. Conclusion The TCM characteristics of hypoproteinemia induced by hepatitis cirrhosis is spleen deficiency with insufficiency of kidney essence as the root and the obstruction of phlegm, stasis and toxin in collaterals as the tip. Fubai Formula can relieve the symptoms and improve the content of serum albumin, and its mid-term and long-term effect is more significant.