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OBJECTIVE@#To observe the clinical efficacy of umbilical needling therapy of I-Ching at 1 PM to 3 PM for cirrhosis ascites with syndrome of spleen-deficiency and fluid-retention.@*METHODS@#Forty-eight patients of cirrhosis ascites with syndrome of spleen-deficiency and fluid-retention were randomly divided into an observation group and a control group, 24 cases in each one. Both groups were treated with routine treatment of western medicine combined with TCM decoction. In addition, the patients in the observation group were treated with umbilical needling therapy of I-Ching at locations of , , and . The treatment was given at 1 PM to 3 PM, once a day; 10-d treatment was a course of treatment, and a total of 20-d treatment was given. The abdominal circumference, urine volume, body mass, liver function and prothrombin time were observed before and after treatment in the two groups, and the clinical efficacy of the two groups was compared.@*RESULTS@#The total effective rate was 91.7% (22/24) in the observation group, which was higher than 87.5% (21/24) in the control group (<0.05). After treatment, the improvement of abdominal circumference, urine volume, body mass, liver function and prothrombin time between the two groups was significantly different (<0.05), the observation group was better.@*CONCLUSION@#Based on the western medicine treatment, the combination of TCM decoction and umbilical needling therapy of I-Ching shows significant efficacy for cirrhosis ascites with syndrome of spleen-deficiency and fluid-retention.
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Humans , Ascites , Therapeutics , Liver Cirrhosis , Needles , Spleen , Syndrome , UmbilicusABSTRACT
OBJECTIVE:To evaluate the efficacy and safety of tolvaptan in the treatment of liver cirrhosis ascites with hyponatremia systematically,in order to provide reference for clinical drug use. METHODS:Retrieved from The Cochrane Library, PubMed,CNKI and Wanfang database,etc.,randomized controlled trials(RCTs)about tolvaptan combined with routine treatment plan(trial group)versus routine treatment plan with or without placebo(control group)in the treatment of liver cirrhosis ascites with hyponatremia were collected. The qualities of included studies were evaluated according to modified Jadad scale after extracting data. Meta-analysis was performed by using Rev Man 5.3 statistical software. RESULTS:A total of 16 RCTs were included, involving 1 271 patients.The results of Meta-analysis showed that serum sodium concentration[MD=6.51,95%CI(4.64,8.39),P<0.001],24 h urine volume [MD=1.36,95%CI(1.01,1.70),P<0.001],response rate of ascites and edema [RD=0.27,95%CI (0.20,0.35),P<0.001],body weight improvement[MD=-1.11,95%CI(-1.31,-0.91),P<0.001]and abdomen circumference improvement [MD=-2.13,95%CI(-2.96,-1.31),P<0.001] of trial group were significantly superior to those of control group, with statistical significance.There was no statistical significance in the levels of blood potassium,blood pressure,heart rate,TBiL,Scr or BUN between 2 groups before and after treatment(P>0.05). The level of ALT in trial group was significantly lower than control group,with statistical significance(P=0.003). Subgroup analysis showed that there was no statistical significance in 24 h urine volume when traditional diuretics were given only in control group or not used in two groups(P>0.05);the serum sodium concentration and 24 h urine volume of other subgroups were significantly higher than those of control group,with statistical significance(P<0.001). The incidence of ADR in trial group was higher than control group as dry mouth,thirst,frequent urination,insomnia,with statistical significance(P<0.05). Total incidence of ADR in trial group was slightly higher than control group,without statistical significance (P>0.05). CONCLUSIONS:Tolvaptan has good therapeutic efficacy for liver cirrhosis ascites with hyponatremia,can effectively improves serum sodium concentration,24 h urine volume,ascites and edema,body weight and abdomen circumference,but rarely affects blood potassium,heart rate,blood pressure,liver and renal function.However,ADR as thirst should be paid attention.
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Objective To evaluate the diagnostic value of serum procalcitonin (PCT) and C-Reactive protein(CRP) in cirrhosis patients with spontaneous peritonitis(SBP). Methods 45 cirrhosis patients with SBP(cirrhosis, spontaneous peritonitis group) and 52 cirrhosis patients without SBP(cirrhosis, non peritonitis group) in the department of Gastroenterology, Anji people's Hospital from January 2010 to January 2015 were enrolled, the serum PCT levels of 2 groups were detected by immune luminescence, and the serum CRP levels of 2 groups were detected by latex enhanced turbidimetric immunoassay, then the differences between the two groups were compared. Results Compared with cirrhosis patients without SBP, the PCT and CRP level have significantly increased in cirrhosis patients with SBP, and the sensitivity and specificity of PCT were higher than CRP, also, PCT combined with CRP test was more sensitive and specific than tested alone. Conclusion PCT combined with CRP test have great sensitivity and specificity in the diagnosis of cirrhosis ascites patients with SBP, and can be considered as the early diagnostic indictors of SBP.
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Objective To evaluate the diagnostic value of serum procalcitonin (PCT) and C-Reactive protein(CRP) in cirrhosis patients with spontaneous peritonitis(SBP). Methods 45 cirrhosis patients with SBP(cirrhosis, spontaneous peritonitis group) and 52 cirrhosis patients without SBP(cirrhosis, non peritonitis group) in the department of Gastroenterology, Anji people's Hospital from January 2010 to January 2015 were enrolled, the serum PCT levels of 2 groups were detected by immune luminescence, and the serum CRP levels of 2 groups were detected by latex enhanced turbidimetric immunoassay, then the differences between the two groups were compared. Results Compared with cirrhosis patients without SBP, the PCT and CRP level have significantly increased in cirrhosis patients with SBP, and the sensitivity and specificity of PCT were higher than CRP, also, PCT combined with CRP test was more sensitive and specific than tested alone. Conclusion PCT combined with CRP test have great sensitivity and specificity in the diagnosis of cirrhosis ascites patients with SBP, and can be considered as the early diagnostic indictors of SBP.
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Ascites is the most common complication of liver cirrhosis, and prevention and control of the development and progression of ascites are the key to improving the prognosis of patients with liver cirrhosis. This article summarizes the new advances in the treatment of ascites, including the update on first-line therapeutic methods such as etiological treatment, limited intake of sodium, and diuretic treatment, and investigates the treatment of intractable ascites.
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Objective To observe the therapeutic effects of medicated thread moxibustion of traditional Zhuang nationality medicine combined with Shugan Jianpi Decoction for cirrhosis ascites. Methods Sixty patients with cirrhosis ascites were randomly divided into observation group and control group by random number method, 30 cases in each group. The treatment group received medicated thread moxibustion of traditional Zhuang nationality medicine combined with Shugan Jianpi Decoction and regular Western medicine; while control group only received regular Western medicine. Two weeks was a course of treatment. The liver function (ALT, AST, TBIL, ALB, A/G), ascites integral changes and improving time of main clinical symptoms (abdominal distension, pain, anorexia, fatigue) were observed. The clinical curative effects of two groups were evaluated with 3 months of follow-up. Results The liver function (ALT, AST, TBIL, ALB, A/G) in the treatment group after treatment was significantly improved, and the ascites integral decreased, which was better than the control group, with statistical significance (P<0.05). The improving time of main clinical symptoms in the treatment group was significantly shorter than the control group (P<0.05);The clinical effective rate was 90.00%(27/30) in the treatment group and 76.67% (23/30) in the control group, with statistical significance (P<0.05). Conclusion Medicated thread moxibustion of traditional Zhuang nationality medicine combined with Shugan Jianpi Decoction has good efficacy for cirrhosis ascites.
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Objective To compare sodium supplement and sodium restriction to the effect of the extinction and prognosis of liver cirrhosis ascites, and research the relationship between live cirrhosis ascites and plasma sodium.Methods 119 liver cirrhosis patients were randomly divided into 2 groups :60 cases of sodium supplement and 59 cases of sodium restriction. 60 cases of sodium supplement was kept low-salt diet and intravenous sodium chloride supplement(3 ～5 g/d) ,59 cases of sodium restriction was only kept low-salt diet. Plasma sodium,plasma chloride,urine sodium, urine sodium chloride were detected before treatment, and 6 days, 10 days after treatment respectively. And the urine quantity,extinction of ascites and prognosis were compared. Results There were significant differences on the increase of plasma sodium,plasma chloride,urine sodium,urine chloride and urine quantity after treatment in two groups. Extinction time of ascites was shorter in group of sodium supplement. The morbidity and fatality rate of hepatic encephalopathy, and hepatorenal syndrome in the group of sodium supplement were lower than that in the group of sodium restriction. Conclusion Sodium supplement should be adapted when using diuretic agent to help the extinction of ascites, and to improve recovery.