中西医结合治疗晚期血吸虫性肝硬化腹水

目的:探索西药联合桃红四物汤加减治疗晚期血吸虫性肝硬化腹水的效果。方法:将68例晚期血吸虫性腹水型患者随机分为对照组和治疗组各34例,对照组采取休息、限钠、限水、护肝、利尿、输注白蛋白及支持等治疗,治疗组在对照组基础上予桃红四物汤治疗,中药治疗持续3⁶个月。两组均治疗15 d和30 d后进行疗效对比,并观察症状和体征、肝肾功能及电介质、腹水复发情况(每3个月随访1次)及肝纤维化指标。结果:治疗15 d后治疗组总有效率为73.5%,对照组总有效率为50.0%,两组总有效率有显著性差异(P<0.05)。治疗30 d后治疗组显效21例,有效7例,总有效率为82.4%;对照组显效14例,有效12例,总有效率为76.5%:两组总有效率比较无明显差异(P>0.05),但显效率有显著性差异(P<0.05),治疗组明显优于对照组。随访3年,治疗组腹水复发率68.2%,对照组76.2%,两组无显著性差异(P>0.05);治疗组腹水复发时间平均23.2个月,对照组平均16.3个月,治疗组复发时间明显延长(P<0.05)。结论:桃红四物汤加减联合西药治疗晚期血吸虫性腹水疗效优于单纯西药治疗。

Integrated TCM and WM Treatment for Advanced Schistosomiasis-induced Cirrhosis Ascites

Objective： To explore the clinical effect of western medicine combined with Taohongsiwu decoction for advanced Schistosomiasis-induced cirrhosis ascites. Method： 68 Patients with advanced schistosomiasis ascites were randomly divided into two groups, the treatment group and the control group, each group consisting of 38 cases. Patients in control group were subjected to rest,limited salt and water intake, and supportive measures to protect liver, facilitate urination, and inject albumin, etc. Patients in treatment group, besides the measures applied to patients in control group, were continuously administered Taohongsiwu decoction for 3~6 months.After 15 days and 30 days, symptoms and physical indicators of patients in both groups, such as liver and renal function, electrolyte,relapse of ascites and liver fibrosis level, were respectively observed and compared（with a follow-up visit every 3 months）. Results： After15 days, total effective rate of treatment group reached 73.5%, and the figure of control group stood 50.0%, the difference between the two groups was statistically significant（P〈0.05）. After 30 days, 21 patients in treatment group witnessed significant recovery, and 7 showed improvement, the total effective rate was 82.4%. By contrast, 14 patients in control group witnessed significant recovery and 12 showed improvement, the total effective rate was 76.5%. The total effective rates of the two groups showed no statistical significance（P〉0.05）.But the significant effective rates had statistical significance with the rate of the treatment group noticeably higher than that of the control group（P〈0.05）. In the following three years, the relapse rate of the treatment group was 68.2%, while that in the control group was76.2%. The relapse rates of the two groups showed no significant difference（P〉0.05）. The average gap between relapses of treatment group was 23.2 months, which was much longer than 16.3 months in control group（P〈0.05）. Conclusion： Taohongsiwu decoction c