CAJ | 학술논문

目的：探讨中西医结合治疗乙型肝炎后肝硬化腹水患者的临床疗效。方法将60例确诊为乙型肝炎后肝硬化腹水患者随机分为对照组和治疗组。对照组30例采用利尿剂、护肝药物以及阿德福韦酯治疗，同时根据实际情况补充白蛋白及血浆；治疗组30例在对照组治疗的基础上加用中药治疗。2组均以4周为1个疗程，治疗2个疗程。2组停用其他药物后继续使用阿德福韦酯进行抗HBV治疗。在治疗过程中，观察2组患者临床症状和体征，ALT、AST、Alb、Glo、TBil等肝功能和乙型肝炎指标（包括HBsAg、抗-HBs、HBeAg、抗-HBe、抗HBc、HBV DNA）的变化，腹部B超检查肝脏大小、脾脏厚度、门脉内径以及腹水程度。结果经过2个疗程的治疗后，2组患者临床症状和体征都得到不同程度的改善，对照组总有效率为67％，治疗组总有效率为90％，组间比较差异有统计学意义（ P＜0．05），2组血清ALT、AST、Alb、Glo、A/G、TBil、HBV DNA转阴率和HBeAg转阴率以及HBV DNA载量都得到明显改善，且2组间各指标比较，治疗组改善更加明显（P均＜0．05）。治疗组腹水复发率低于对照组（P＜0．05）。结论中西医结合治疗肝硬化腹水临床疗效好，值得临床推广应用。
목적：탐토중서의결합치료을형간염후간경화복수환자적림상료효。방법장60례학진위을형간염후간경화복수환자수궤분위대조조화치료조。대조조30례채용이뇨제、호간약물이급아덕복위지치료，동시근거실제정황보충백단백급혈장；치료조30례재대조조치료적기출상가용중약치료。2조균이4주위1개료정，치료2개료정。2조정용기타약물후계속사용아덕복위지진행항HBV치료。재치료과정중，관찰2조환자림상증상화체정，ALT、AST、Alb、Glo、TBil등간공능화을형간염지표（포괄HBsAg、항-HBs、HBeAg、항-HBe、항HBc、HBV DNA）적변화，복부B초검사간장대소、비장후도、문맥내경이급복수정도。결과경과2개료정적치료후，2조환자림상증상화체정도득도불동정도적개선，대조조총유효솔위67％，치료조총유효솔위90％，조간비교차이유통계학의의（ P＜0．05），2조혈청ALT、AST、Alb、Glo、A/G、TBil、HBV DNA전음솔화HBeAg전음솔이급HBV DNA재량도득도명현개선，차2조간각지표비교，치료조개선경가명현（P균＜0．05）。치료조복수복발솔저우대조조（P＜0．05）。결론중서의결합치료간경화복수림상료효호，치득림상추엄응용。
Objective It is to investigate the clinical effect of western medicine integrated with traditional Chinese medi -cine in treatment of patients with ascites due to hepatitis B hepatic cirrhosis .Methods 60 patients with ascites due to hepatitis B hepatic cirrhosis were randomly divided into two groups .30 patients in control group were treated with diuretics , liver pro-tection drugs and adefovir dipivoxil ( ADV) .Albumin and plasma was filling upped at the same time according to the actual situation.While 30 patients in treatment group were treated with diuretics and liver protection drugs combined with traditional Chinese medicine .4 weeks is a course of treatment , and both groups were treated for 2 course of treatment .ADV were used to continue to treat patients when other drugs were stoped after 2 course of treatment .After treatment process , symptoms and signs,liver function indexes such as alanine aminotransferase ( ALT), aspartate aminotransferase (AST), albumin (Alb), globulin (Glo), Alb and Glo ratio (A/G), as well as total bilirubin (TBil), hepatitis B indexes, such as HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc, HBV DNA, liver size, thickness of spleen , portal vein diameter and degree of ascites exam-ined by abdominal B-mode ultrasonography were observed .Results After 2 course of treatment , symptoms and signs in both control group and treatment group have been improved at different degrees , and the effective total rate was 67% of control group, while 90%of treatment group, there was significant difference between the two groups (P<0.05).Liver function in-dexes such as ALT , AST, Alb, Glo, A/G as well as TBil , negative conversion rate of HBV DNA as well as HBeAg and load of HBV DNA in both groups were significantly improved after treatment , and there were significant difference between the both groups (all P<0.05).The recurrence rate of ascites in treatment group was markedly lower than control group (P<0.05). Conclusion There is significant clinical effect of western medicine integrated with traditional Chinese medicine in treatment of patients with ascites due to hepatic cirrhosis .The treatment protocols is worthy of clinical popularization and application .