吴芳　杨文军

[摘要] 目的 探討中西医结合治疗对乙型肝炎腹水患者疗效及生存质量的影响。 方法 选取2015年1月～2016年10月间我院收治的124例乙型肝炎腹水患者作为研究对象，采用随机数字表法分为观察组和对照组各62例。对照组患者单用拉米夫定治疗，观察组患者则在对照组治疗基础上加用当飞利肝宁治疗，治疗4个月后评价疗效，对比两组患者的疗效、腹水消退情况、肝功能主要指标改善及生活质量评分情况。 结果 观察组患者总有效率为91.9%（57/62），对照组总有效率为72.6%（45/62），两组比较差异有统计学意义（P<0.05）；两组患者治疗后尿量、腹围、体重较治疗前均有显著改善（P<0.05），且观察组尿量及体重改善程度显著优于对照组（P<0.05）；治疗后两组患者的ALT、AST、TBIL较治疗前均显著改善（P<0.05），且观察组改善程度均显著优于对照组（P<0.05）；SF-36评分统计结果显示，观察组患者生理机能、生理职能、躯体疼痛、精力、一般健康状况评分改善程度均显著优于对照组（P<0.05）。 结论 中西医结合治疗乙型肝炎腹水的疗效确切，相较于单纯应用拉米夫定治疗可更好地控制症状，改善肝功能，提高患者的生存质量，值得在临床上推广和应用。

[关键词] 乙型肝炎；腹水；中西医结合；生存质量

[中图分类号] R575.1 [文献标识码] A [文章编号] 1673-9701（2017）16-0001-03

Evaluation of the effect of integrated traditional Chinese and western medicine on the quality of life in the patients with hepatitis B ascites

WU Fang YANG Wenjun

Department of Gastroenterology，the First Hospital Affiliated to Wenzhou Medical University，Wenzhou 325000，China

[Abstract] Objective To explore the effect of integrated traditional Chinese and western medicine on the efficacy and quality of life in the patients with hepatitis B ascites. Methods A total of 124 patients with hepatitis B hepatic ascites who were admitted to our hospital from January 2015 to October 2016 were selected as the study subjects. The patients were divided into observation group and control group according to the random number table method， with 62 cases in each group. The patients in the control group were treated with lamivudine alone， and the observation group was given Dangfei Liganning on the basis of the control group. After 4 months of treatment， the efficacy was evaluated. The efficacy， ascites alleviation， improvement of main liver function indices and quality of life scores were compared between the two groups. Results The total effective rate was 91.9%（57/62） in the observation group， and the total effective rate was 72.6%（45/62） in the control group. The difference between the two groups was statistically significant（P<0.05）； the urine volume， abdominal circumference and body weight in the two groups were significantly improved after the treatment（P<0.05）， and the improvement of urine volume and body weight in the observation group were significantly better than those in the control group（P<0.05）； after the treatment， ALT， AST and TBIL in both groups were significantly improved compared with those before the treatment （P<0.05）， and the improvement in the observation group was significantly better than that in the control group（P<0.05）； the statistical results of SF-36 scores showed that the improvement of the scores of physiological mechanism， physiological function， body pain， energy and general health status in the observation group were significantly better than those in the control group（P<0.05）. Conclusion The curative effect of integrated traditional Chinese and western medicine in the treatment of hepatitis B ascites is more accurate. Compared with the application of lamivudine alone， it can better control the symptoms， improve the liver function and improve the quality of life of patients， which is worthy of clinical popularization and application.

[Key words] Hepatitis B；Ascites；Integrated Chinese and western medicine；Quality of life

乙型肝炎是常见的肝脏传染病，随着近年来环境和饮食结构的改变，乙肝的发生率有所提高。对于慢性乙肝患者而言，由于病程较长、易反复发作，如果未能及时控制治疗，就会进一步加剧肝脏的损害[1，2]。肝硬化、肝腹水是肝脏疾病中晚期的临床表现，肝细胞出现再生结节和弥漫性纤维化，严重影响患者的健康，是乙型肝炎最严重的并发症之一[3，4]，临床主要采用抗纤维化药物进行对症支持治疗，但疗效一般。随着近年来中医药在临床上的广泛应用，此类疾病的治疗也有了更多的选择，当飞利肝宁属于中药制剂，在多种肝损害治疗上均有较好的应用[5，6]，本文就西医常规治疗联合当飞利肝宁用于乙型肝炎腹水患者的疗效进行了研究评价，现报道如下。

1 资料与方法

1.1 一般资……