CAJ | 학술논문

目的观察口服中药联合腹水超滤浓缩回输护理治疗肝硬化顽固性腹水的疗效.方法选择肝硬化顽固性腹水住院患者62例,随机分为两组,治疗组32例,采用口服中药+腹水超滤浓缩回输+基础治疗;对照组30例,采用腹水超滤浓缩回输+基础治疗.疗程均为1个月,腹水超滤浓缩回输的频率为2 w 1次,1次超滤的腹水为3 000～8 000 ml,观察治疗前后患者的体重、腹围、24 h尿量、血浆白蛋白、腹水白蛋白、患者血浆和腹水中内毒素水平的变化.结果两组患者的临床症状均有改善,体重及腹围显著下降,24 h尿量增加,血浆及腹水中蛋白量增加,血浆中内毒素水平较治疗前显著下降;治疗组患者腹水Ⅰ级消退者18例,占56.3%,对照组4例,占13.3%,与对照组比较差异有显著性意义(P<0.05).结论中药口服联合腹水超滤浓缩回输治疗肝硬化顽固性腹水有较好疗效,其作用机制可能与改善患者血浆内毒素水平有关.
목적 관찰구복중약연합복수초려농축회수호리치료간경화완고성복수적료효.방법 선택간경화완고성복수주원환자62례,수궤분위량조,치료조32례,채용구복중약+복수초려농축회수+기출치료;대조조30례,채용복수초려농축회수+기출치료.료정균위1개월,복수초려농축회수적빈솔위2 w 1차,1차초려적복수위3 000～8 000 ml,관찰치료전후환자적체중、복위、24 h뇨량、혈장백단백、복수백단백、환자혈장화복수중내독소수평적변화.결과량조환자적림상증상균유개선,체중급복위현저하강,24 h뇨량증가,혈장급복수중단백량증가,혈장중내독소수평교치료전현저하강;치료조환자복수Ⅰ급소퇴자18례,점56.3%,대조조4례,점13.3%,여대조조비교차이유현저성의의(P<0.05).결론 중약구복연합복수초려농축회수치료간경화완고성복수유교호료효,기작용궤제가능여개선환자혈장내독소수평유관.
Objective To observe the effect of oral TCM combining with ascites concentration re - trans-fusion on the patients with refractory cirrhosis ascites. Methods 62 inpatients with refractory cirrhosis ascites were divided into two groups randomly: 32 cases of the treatment group were treated with TCM + ascites concentration re-transfusion + basic therapy; 30 cases of the control group were treated with ascites concentration re -transfusion + basic therapy. The course of treatment was 1 month. The frequency of ascites concentration re - trans-fusion was once per two weeks, and the volume of ascites concentration for one time was 3 000～8 000 mL The changes of body weight, abdomen circumference, 24 hours urinary output, plasma - albnmin, ascites - albumin and the endotoxin level in plasma and ascites before and after the treatment were observed. Results The clinical symptoms of both groupa were improved. The body weight and abdomen circumference were obviously decreased; 24 hours urinary output, plasma - albumin and recites - albumin were increased. The endotoxin level in plasma was obviously decreased after treatment. 18 cases with the ascites decreasing quantity above Ⅰ level from the treatment group was account of 56.3%, while 4 cases from the control group was account of 13.3%. There was significant difference between treatment group and control group (P<0.05) . Conclusions Oral TCM combining with ascites concentration re - transfusion to treat refractory cirrhosis ascites show better therapeutic effect. The probable mechanism may be related with the descending plasma endotoxin level in patients.