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[目的]观察清肠汤灌肠联合西药治疗肝硬化腹水并发自发性细菌性腹膜炎疗效。[方法]使用随机平行对照方法,将40例住院患者按简单随机分为两组。对照组20例抗感染、护肝、利尿、调节免疫、维持水电解质平衡及支持对症治疗;抗生素(头孢曲松钠或头孢哌哃钠舒巴坦钠联合左氧氟沙星),静脉给药,2次/d。治疗组20例清肠汤免煎颗粒,大黄颗粒5g,金银花颗粒4g,白头翁颗粒1g,丹参颗粒4g,赤芍颗粒3g,温水冲200mL,药液温度28℃~30℃,保留灌肠,灌完后左侧卧位,药液在肠腔内保留>30min,1次/d;西药治疗同对照组。连续治疗2周为1疗程。观测临床症状、WBC、PMN、不良反应。治疗1疗程,判定疗效。[结果]临床疗效治疗组优于对照组(P<0.05)。腹水WBC、PMN水平两组均有改善(P<0.01),治疗组改善优于对照组(P<0.05)。[结论]清肠汤灌肠联合西药治疗肝硬化腹水并发自发性细菌性腹膜炎,疗效满意,无严重不良反应,值得推广。
[Objective] To observe the curative effect of Qingchang Decoction combined with western medicine in the treatment of spontaneous bacterial peritonitis in patients with cirrhosis and ascites. [Method] Using randomized parallel control method, 40 inpatients were randomly divided into two groups randomly. In the control group, 20 cases were treated with antibiotics (such as ceftriaxone sodium or cefoperazone sodium and sulbactam sodium combined with levofloxacin), intravenous injection, twice / d. The treatment group, 20 cases of Qingchang Decoction particles, rhubarb particles 5g, honeysuckle particles 4g, Pulsatilla particles 1g, Danshen particles 4g, red peony particles 3g, warm water red 200mL, liquid temperature 28 ℃ ~ 30 ℃, retention enema, irrigation finished After the left lateral decubitus, liquid retention in the intestine> 30min, 1 / d; western medicine treatment with the control group. Continuous treatment for 2 weeks for a course of treatment. Observed clinical symptoms, WBC, PMN, adverse reactions. Treatment of a course of treatment to determine the efficacy. [Results] The clinical curative effect was better than the control group (P <0.05). Ascites WBC, PMN levels were improved in both groups (P <0.01), the treatment group improved better than the control group (P <0.05). [Conclusion] Intestinal bowel combined with Western medicine in treating cirrhosis with spontaneous bacterial peritonitis has satisfactory curative effect and no serious side effects. It is worth popularizing.