宣肺健脾温肾法联合西药对肝硬化顽固性腹水患者的临床疗效

目的观察宣肺健脾温肾法联合西药对肝硬化顽固性腹水患者的临床疗效。方法 100例患者随机分为对照组和观察组,每组50例,对照组给予西药(托伐普坦、还原性谷胱甘肽、呋塞米),观察组在对照组基础上加用宣肺健脾温肾法,疗程14 d。然后,检测临床疗效、临床体征(腹胀、纳差、乏力、腹围、24 h尿量)、彩超相关指标(门静脉血流量、脾静脉血流量、腹水暗区深度)、肝功能指标[丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、谷氨酰转移酶(GGT)、总胆红素(TBIL)、白蛋白(ALB)、白蛋白与球蛋白比值(A/G)]、肾功能指标(尿素、肌酐)、体液免疫学指标[免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、免疫球蛋白A(IgA)]、细胞免疫学指标(CD3 ^+、CD4 ^+、CD4^+/CD8^+)及血清P-选择素、细胞间黏附分子-1(ICAM-1)表达变化。结果观察组总有效率显著高于对照组(P<0.05)。治疗后,观察组临床体征、彩超相关指标、肝肾功能指标、免疫学指标显著优于对照组(P<0.05);2组P-选择素、ICAM-1表达显著降低(P<0.05),以观察组更明显(P<0.05)。结论宣肺健脾温肾法联合西药可降低肝硬化顽固性腹水患者血清P-选择素、ICAM-1表达,改善肝肾功能和免疫力,减少腹水量。

Clinical effects of Xuanfei Jianpi Wenshen Method combined with synthetic medications on cirrhotic patients with refractory ascites

AIM To observe the clinical effects of Xuanfei Jianpi Wenshen Method combined with synthetic medications on cirrhotic patients with refractory ascites. METHODS One hundred patients were randomly assigned into control group(50 cases) for 14-day administration of synthetic medications(tolvaptan, reduced glutathione, furosemide), and observation group(50 cases) for 14-day administration of Xuanfei Jianpi Wenshen Method and synthetic medications. Subsequently, the changes in clinical efficacy, clinical signs(abdominal distension, anorexia, fatigue, abdominal circumference, 24 h urine volume), color ultrasound-related indices(portal vein blood flow, splenic venous blood flow, deep ascites depth), hepatic function indices[alanine aminotransferase(ALT), aspartate aminotransferase(AST), glutamyl transferase(GGT), total bilirubin(TBIL), albumin(ALB), albumin to globulin ratio(A/G)], renal function indices(urea, creatinine), humoral immunological indices[immunoglobulin G(IgG), immunoglobulin M(IgM), immunoglobulin A(IgA), cellular immunological indices(CD3^+, CD4^+, CD4^+/CD8^+), and serum P-selectin and intercellular adhesion molecule-1(ICAM-1) expressions were detected. RESULTS The observation group demonstrated significantly higher total effective rate than the control group(P<0.05). After the treatment, the observation group displayed markedly better clinical signs, color ultrasound-related indices, liver and kidney function indices, and immunological indices than the control group(P<0.05), and the two groups exhibited obviously decreased P-selectin and ICAM-1 expressions(P<0.05), the observation group took the lead(P<0.05). CONCLUSION For the cirrhotic patients with refractory ascites, Xuanfei Jianpi Wenshen Method combined with synthetic medications can decrease serum P-selectin and ICAM-1 expressions, improve liver and kidney functions, immunity, and reduce ascites volume.