消胀散辨证敷脐治疗肝硬化腹水的临床研究张雅丽蔡俊萍郑霞上海.DOC

PAGE PAGE 6 消胀散辨证敷脐治疗肝硬化腹水的临床研究 张雅丽 蔡俊萍 郑霞 （上海中医药大学附属曙光医院 上海 200021） 摘要:目的　研究消胀散辨证敷脐治疗肝硬化腹水的临床疗效。方法　选择肝硬化腹水住院患者62 例,其中实证31 例,分为实证对照组10 例、实证实验组21 例;虚证31 例,分为虚证对照组11例、虚证实验组20 例。由黄芪、附子和麝香等组成虚胀方,由大黄、莱菔子和麝香等组成实胀方,制成巴布剂。对照组采用一般治疗,实证与虚证实验组在此基础上分别以消胀散之实胀方或虚胀方巴布剂敷脐。观察两组患者临床症状、体重、腹围、尿量与腹水情况。结果　与相应对照组比较,实验组体重减轻,腹围缩小,腹水减少,而且尿量与排气明显增加;且实证敷脐实验组疗效较好。实验组出现不良反应有皮肤红疹水疱,胶布过敏,经处理后症状消失。结论　消胀散敷脐用于肝硬化腹水患者,效果好且不良反应少,操作简单,患者依从性好,卫生经济效价比高。 关键词:肝硬化;腹水;消胀散;敷脐; Clinical Study of Topical Application of“Xiaozhang San”on Umbilical Area to Treat Ascites of Liver Cirrhosis 　( Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine , Shanghai 200021 , China) ZHANG Ya2li , CAI Jun2ping , ZHENG Xia Abstract : Objective 　To observe the effect of Xiaozhang San applied to umbilical area in treating ascites of liver cirrhosis.Methods 　Sixty-two inpatients with liver cirrhosis were chosen. Thirty one“excess-type”cases were randomly divided into control group ( n = 10) and test group ( n = 21) ;31“deficiency-type”cases including control group ( n = 11) and test group ( n = 20) . The prescription for“deficiency-type”distension composed of Radix Astragali seu Hedysari , Radix Aconiti Praeparata and Moschus ,that for“excess-type”distension composed of Radix et Rhizoma Rhei , Semen Raphani and Moschus were made into“Ba Bu”preparations. Control groups received the usual treatment with diuretic. The two test groups were treated with the respective“Ba Bu”preparation. Patients were closely observed for symptoms , body weight , abdominal circumference ,urinary output and amount of ascites by ultrasonic examination to determine therapeutic effects. Results 　Compared with control groups , test groups of both types showed weight reduction , decrease of abdominal circumference , improvement of ascites and marked increase of urinary output and increased flatus. The effect in “excess-type”was even better. In both test groups , side-effects included slight local skin blisters and adhesive